scholarly journals Statin Use is Associated With The Reduction in Hepatocellular Carcinoma Recurrence After Liver Surgery

2021 ◽  
Author(s):  
Elias Khajeh ◽  
Arash Dooghaie Moghadam ◽  
Pegah Eslami ◽  
Sadeq Ali-Hasan-Al-Saegh ◽  
Ali Ramouz ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Surgery ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Research Assessment ◽  
Assessment Development ◽  
Statin Group ◽  
Hepatocellular Carcinoma Recurrence ◽  
One Year ◽  
Hcc Recurrence

Abstract Background Hepatocellular carcinoma (HCC) is the sixth most common form of cancer worldwide. Although surgical treatments have an acceptable cure rate, tumor recurrence is still a challenging issue. In this meta-analysis, we investigated whether statins prevent HCC recurrence following liver surgery. Methods PubMed, Web of Science, EMBASE and Cochrane Central were searched. The Outcome of interest was the HCC recurrence after hepatic surgery. Pooled estimates were represented as hazard ratios (HRs) and odds ratios (ORs) using a random-effects model. Summary effect measures are presented together with their corresponding 95% confidence intervals (CI). The certainty of evidence was evaluated using the Grades of Research, Assessment, Development and Evaluation (GRADE) approach. Results The literature search retrieved 1,362 studies excluding duplicates. Nine retrospective studies including 44,219 patients (2,243 in the statin group and 41,976 in the non-statin group) were included in the qualitative analysis. Patients who received statins had a lower rate of recurrence after liver surgery (HR: 0.41; 95% CI: 0.31– 0.54; p <0.001). Moreover, Statins decreased the recurrence one year after surgery (OR: 0.27; 95% CI: 0.16–0.47; P < 0.001), three years after surgery (OR: 0.22; 95% CI: 0.15–0.33; P < 0.001), and five years after surgery (OR: 0.28; 95% CI: 0.19–0.42; P < 0.001). The certainty of evidence for the outcomes was moderate. Conclusion Statins increase the disease-free survival of patients with HCC after liver surgery. These drugs seem to have chemoprevention effects that decrease the probability of HCC recurrence after liver transplantation or liver resection.

scholarly journals Evaluation of Antiviral Therapy Performed after Curative Therapy in Patients with HBV-Related Hepatocellular Carcinoma: An Updated Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Peng Yuan ◽  
Peng Chen ◽  
Yeben Qian
Keyword(s):  
Hepatocellular Carcinoma ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Curative Therapy ◽  
B Virus ◽  
Effect Of Treatment ◽  
Long Term Prognosis ◽  
One Year ◽  
The One ◽  
The Impact

Background.The long-term prognosis after curative therapy for hepatitis B virus- (HBV-) related hepatocellular carcinoma (HCC) remains unsatisfactory due to the high incidence of recurrence. The effect of treatment with nucleotide analogues (NAs) in patients with HBV-related HCC after curative therapy remains unclear.Objective.To assess the impact of using NAs after curative therapy.Method.A computerized literature search was performed; eligible studies were identified from databases. The pooled risk ratios (RRs) and 95% CIs were calculated using Review Manager 5.3.Result.The meta-analysis included a total of 15 studies with 8060 patients. The one-year and three-year recurrence (one-year recurrence: RR 0.41 [95% CI 0.28 to 0.61];P<0.00001; three-year recurrence: RR 0.63 [95% CI 0.43 to 0.94];P=0.001) and the one-, three-, and five-year overall survival (OS) and disease-free survival (DFS) were significantly better in the treatment group.Conclusion.NAs can reduce the recurrence and improve the prognosis of HBV-related HCC after curative therapy.

scholarly journals Meta-analysis of short- and long-term outcomes after pure laparoscopic versus open liver surgery in hepatocellular carcinoma patients

2018 ◽  
Vol 33 (5) ◽  
pp. 1491-1507 ◽  
Author(s):  
Jan Witowski ◽  
Mateusz Rubinkiewicz ◽  
Magdalena Mizera ◽  
Michał Wysocki ◽  
Natalia Gajewska ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Surgery ◽  
Meta Analysis ◽  
Long Term Outcomes ◽  
Short And Long Term

Hepatocellular carcinoma recurrence after direct-acting antiviral therapy: an individual patient data meta-analysis

Gut ◽  
2021 ◽  
pp. gutjnl-2020-323663
Author(s):  
Victor Sapena ◽  
Marco Enea ◽  
Ferran Torres ◽  
Ciro Celsa ◽  
Jose Rios ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Propensity Score ◽  
Individual Patient Data ◽  
Meta Analysis ◽  
Recurrence Risk ◽  
Patient Data ◽  
Death Risk ◽  
Significant Difference ◽  
Direct Acting ◽  
Hcc Recurrence

ObjectiveThe benefit of direct-acting antivirals (DAAs) against HCV following successful treatment of hepatocellular carcinoma (HCC) remains controversial. This meta-analysis of individual patient data assessed HCC recurrence risk following DAA administration.DesignWe pooled the data of 977 consecutive patients from 21 studies of HCV-related cirrhosis and HCC, who achieved complete radiological response after surgical/locoregional treatments and received DAAs (DAA group). Recurrence or death risk was expressed as HCC recurrence or death per 100 person-years (100PY). Propensity score-matched patients from the ITA.LI.CA. cohort (n=328) served as DAA-unexposed controls (no-DAA group). Risk factors for HCC recurrence were identified using random-effects Poisson.ResultsRecurrence rate and death risk per 100PY in DAA-treated patients were 20 (95% CI 13.9 to 29.8, I2=74.6%) and 5.7 (2.5 to 15.3, I2=54.3), respectively. Predictive factors for recurrence were alpha-fetoprotein logarithm (relative risk (RR)=1.11, 95% CI 1.03 to 1.19; p=0.01, per 1 log of ng/mL), HCC recurrence history pre-DAA initiation (RR=1.11, 95% CI 1.07 to 1.16; p<0.001), performance status (2 vs 0, RR=4.35, 95% CI 1.54 to 11.11; 2 vs 1, RR=3.7, 95% CI 1.3 to 11.11; p=0.01) and tumour burden pre-HCC treatment (multifocal vs solitary nodule, RR=1.75, 95% CI 1.25 to 2.43; p<0.001). No significant difference was observed in RR between the DAA-exposed and DAA-unexposed groups in propensity score-matched patients (RR=0.64, 95% CI 0.37 to 1.1; p=0.1).ConclusionEffects of DAA exposure on HCC recurrence risk remain inconclusive. Active clinical and radiological follow-up of patients with HCC after HCV eradication with DAA is justified.

Role of Sorafenib in Patients With Recurrent Hepatocellular Carcinoma After Liver Transplantation

2016 ◽  
Vol 26 (4) ◽  
pp. 348-355 ◽  
Author(s):  
Nicola de’Angelis ◽  
Filippo Landi ◽  
Marco Nencioni ◽  
Anais Palen ◽  
Eylon Lahat ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Survival Rates ◽  
Early Recurrence ◽  
Best Supportive Care ◽  
Curative Intent ◽  
Sorafenib Group ◽  
Hepatocellular Carcinoma Recurrence ◽  
Retrospective Comparative Study ◽  
Hcc Recurrence

Context: The management of hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT) is challenging, especially if it is not treatable by surgery or embolization. Objectives: The present study aims to compare the survival rates of liver transplanted patients receiving sorafenib or best supportive care (BSC) for HCC recurrence not amenable to curative intent treatments. Design: This is a retrospective comparative study on a prospectively maintained database. Participants: Liver transplanted patients with untreatable HCC recurrence receiving BSC (n = 18) until 2007 or sorafenib (n = 15) thereafter were compared. Results: No group difference was observed for demographic characteristics at the time of transplantation and at the time of HCC recurrence. On the explant pathology of the native liver, 81.2% patients were classified within the Milan criteria, and 53.1% presented with microvascular invasion. Hepatocellular carcinoma recurrence was diagnosed 17.8 months (standard deviation: 14.5) after LT, with 17 (53.1%) patients presenting with early recurrence (≤12 months). The 1-year survival from untreatable progression of HCC recurrence was 23.9% for the BSC and 60% for the sorafenib group ( P = .002). The type of treatment (sorafenib vs BSC) was the sole independent predictor of survival (hazard ratio: 2.98; 95% confidence interval: 1.09-8.1; P = .033). In the sorafenib group, 8 (53.3%) patients required dose reduction, and 2 (13.3%) patients discontinued the treatment due to intolerable side effects. Conclusion: Sorafenib improves survival and is superior to the BSC in cases of untreatable posttransplant hepatocellular carcinoma recurrence.

scholarly journals Statin Use is Associated With a Lower Risk of Recurrence After Curative Resection in BCLC Stage 0-a Hepatocellular Carcinoma

2020 ◽  
Author(s):  
Shih-Yu Yang ◽  
Chih-Chi Wang ◽  
Kuang-Den Chen ◽  
Yueh-Wei Liu ◽  
Chih-Che Lin ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Curative Resection ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Chang Gung Memorial Hospital ◽  
Statin Group ◽  
Independent Risk Factors ◽  
Hcc Recurrence ◽  
Statin Use

Abstract BackgroundUse of statins is associated with a reduced risk of hepatocellular carcinoma (HCC). However, the effect of statin use on HCC recurrence is unclear. This study aimed to evaluate the effect of statin use on recurrence after curative resection among patients with HCC.MethodsWe retrospectively assessed 820 patients with Barcelona Clinic Liver Cancer (BCLC) stage 0 or A HCC who underwent primary resection between January 2001 and June 2016 at Kaohsiung Chang Gung Memorial Hospital. Exposure to statins was defined as use of a statin for at least 3 months before HCC recurrence. Factors that influenced overall survival (OS) and recurrence-free survival (RFS) were analyzed using Cox proportional hazards models.ResultsOf the 820 patients, 46 (5.6%) used statins (statin group) and 774 (94.4%) did not (non-statin group). During the mean follow-up of 76.5 months, 440 (53.7%) patients experienced recurrence and 146 (17.8%) patients died. The cumulative incidence of HCC recurrence was significantly lower in the statin group than the non-statin group (p = 0.001); OS was not significantly different between groups. In multivariate analysis, age (hazard ratio [HR]: 1.291; p = 0.010), liver cirrhosis (HR: 1.743; p < 0.001), diabetes (HR:1.418; p = 0.001), number of tumors (HR: 1.750; p < 0.001), tumor size (HR: 1.406; p = 0.004) and vascular invasion (HR: 1.659; p < 0.001) were independent risk factors for HCC recurrence, whereas statin use (HR: 0.354; p < 0.001) and antiviral therapy (HR: 0.613; p < 0.001) significantly reduced the risk of HCC recurrence. The statin group still had lower RFS than the non-statin group after one-to-four propensity score matching.ConclusionStatins may exert a chemo-preventive effect on HCC recurrence after curative resection.

scholarly journals Adjuvant Therapy Using Lenvatinib Prevents Recurrence of High-Risk Patients with Hepatitis B Virus-Related Hepatocellular Carcinoma Following Liver Transplantation: A Retrospective Case Control Study

2020 ◽  
Author(s):  
Bing Han ◽  
Han Ding ◽  
Shuai Zhao ◽  
Yichi Zhang ◽  
Jian Wang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
High Risk ◽  
Disease Free Survival ◽  
High Ratio ◽  
Control Group ◽  
Retrospective Case ◽  
High Risk Patients ◽  
Risk Patients ◽  
Hcc Recurrence

Abstract Background: Although liver transplantation (LT) is one of the most effective treatments for the patients with hepatocellular carcinoma (HCC), the high-risk patients suffer from a high ratio of tumor recurrence after LT. So this study was designed to evaluate the role of adjuvant lenvatinib in preventing recurrence of high-risk LT recipients with HBV-related HCC.Methods: We retrospectively analyzed 23 high-risk patients consisting of lenvatinib group (n = 14) and control group (n = 9) with HBV-related HCC who underwent LT in our center. Disease-free survival (DFS) and HCC recurrence of the two groups were compared. The adverse events (AEs) and drug tolerance of lenvatinib were evaluated.Results: The median DFS in lenvatinib group was 291 (95%CI 204–516) days, significantly longer than 182 (95%CI 56–537) days in control group (P = 0.04). Three patients in lenvatinib group (21.4%) and 5 patients in control group (55.6%) had short-term HCC recurrence (P = 0.11). All patients in lenvatinib group could tolerate oral lenvatinib for at least 3 cycles except 6 cases (42.9%) of dose reduction and 1 case of interruption (14.3%). Thirteen patients (92.9%) taking lenvatinib experienced AEs. The most common AEs were hypertension (64.3%) and proteinuria (42.9%), and the most serious AEs were CTCAE Grade 3 for 4 cases (28.5%). Additionally, no influence of lenvatinib on the dosage and blood concentration of FK506 was observed.Conclusion: Adjuvant lenvatinib had a potential benefit on prolonging the DFS and reducing the recurrence of high-risk HBV-related HCC patients following liver transplantation with an acceptable drug safety and patient tolerance.

Surgery alone versus post-operative radiotherapy for sinonasal malignant melanoma: a meta-analysis

2018 ◽  
Vol 132 (12) ◽  
pp. 1051-1060
Author(s):  
R Hu ◽  
B-B Yang
Keyword(s):  
Overall Survival ◽  
Malignant Melanoma ◽  
Local Control ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Free Survival ◽  
Rare Malignancy ◽  
One Year ◽  
Disease Free ◽  
Sinonasal Malignant Melanoma

AbstractObjectiveSinonasal malignant melanoma is a relatively rare malignancy with poor prognosis, and effective treatments remain elusive. This analysis aimed to explore whether post-operative radiotherapy conferred any survival advantages in patients with this disease when compared with surgery alone.MethodsPublished studies were identified by searching four electronic databases. The endpoints evaluated were: rates of overall survival, disease-free survival and local control.ResultsTwenty-eight studies including 1392 patients were identified. The results indicated that post-operative radiotherapy led to a significantly better three-year overall survival rate (p= 0.02), and suggested a borderline significant benefit for five-year overall survival (p= 0.05), when compared with surgery alone. However, no statistical advantage was found for disease-free survival, local control or one-year overall survival.ConclusionThis meta-analysis indicated that adjuvant radiotherapy prolonged survival, but showed no benefit for disease-free survival or local control.

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