Statin Use is Associated with Decreased Hepatocellular Carcinoma Recurrence in Liver Transplant Patients

Yongin Cho,Eun Seok Kang,Chung Mo Nam,Myoung Soo Kim

doi:10.1038/s41598-018-38110-4

Abstract

Statins have been reported to prevent the development of hepatocellular carcinoma (HCC). We examined whether statin therapy is associated with decreased HCC recurrence in patients who underwent liver transplantation for HCC. Three hundred forty-seven patients ≥ 20 years old who underwent liver transplantation for HCC from 2006 to 2016 were enrolled in this study. Statin therapy was defined as the administration of statins for more than 30 days after liver transplantation. One hundred twelve (32.3%) patients treated with statins over 30 days were defined as the statin group, and the remaining 235 (67.7%) were defined as the non-statin group. Several risk factors reported to be associated with HCC recurrence, such as proportion of underlying liver disease, above Milan criteria, differentiation of HCC, vascular invasion, and preoperative alpha-fetoprotein level were not different between the two groups. Time-dependent Cox regression analysis showed that statin treatment was associated with significantly lower recurrence risk of HCC after adjusting for other risk factors (hazard ratio = 0.32, 95% CI = 0.11–0.89).

Highlights

Statins, 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, are lipid-lowering agents that prevent cardiovascular disease and its related mortality[9]
The use of statins was significantly associated with a lower hepatocellular carcinoma (HCC) recurrence rate in LT recipients
This is consistent with results from previous studies, including a recent large-scale cohort analysis, showing that the use of statins reduced the incidence of HCC13,15,18,20

Summary

Introduction

3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, are lipid-lowering agents that prevent cardiovascular disease and its related mortality[9]. Statins showed a remarkably favorable overall safety profile for long-term use in cancer prevention[12]. Studies on the preventive effect of statins on HCC recurrence has been published. Statin have been shown to contribute to the prevention of HCC development in hepatitis B patients[13,14], hepatitis C patients[15,16], patients who underwent initial liver resection due to HCC17, and the general population in a large cohort study[18]. The effect of statins on HCC recurrence in patients who had LT for HCC has not been studied.

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Results

Conclusion