RISS 검색 - 국내학술지논문 상세보기

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Aims: The protective effect of statin on the development of hepatocellular carcinoma (HCC) and survival has been demonstrated from previous observational studies in patients with chronic live disease. However, it is unclear whether statin use is associated with a risk reduction of HCC recurrence in patients who underwent liver transplantation (LT) for HCC.
Methods: Consecutive patients who underwent LT for HCC between January 1995 and December 2019 were enrolled. Patients who used statins for more than 30 days after the date of LT were defined as statin users. Patients were excluded when they were followed up for less than 3 months or HCC recurred within 2 months after LT. We used time-dependent Cox regression models to overcome immortal-time bias.
Results: A total of 430 patients were enrolled and 321 patients (74.7%) were statin non-users and 109 (25.3%) were statin users. During a median follow-up of 64.9 months (range 3.1- 267.5), 298 patients (69.3%) survived and 111 (25.8%) expired. The number of patients within the Milan criteria before LT was 356 out of 427 (83.4%). HCC recurred in 79 (18.4%) patients after a median 11.1 months (range 2.4-150.8) of LT. Statin use was associated with significantly lower risk of HCC recurrence after adjustment of age, sex, history of pre-treatment, trough concentration of calcineurin inhibitor, total cholesterol, AFP, Milan criteria and time-dependent covariates (DM, use of aspirin and metformin) (P=0.043, HR = 0.98, CI 0.95-1.00). Statin users also had a significantly higher overall survival and lower HCC-related mortality than statin non-users (P=0.003 and P=0.042 by Cox regression analysis, respectively). There was a dose-dependent relationship between statin use and HCC recurrence.
Conclusions: Statin use significantly reduced the risk of HCC recurrence and improved survival of patients who underwent LT for HCC.