Antiplatelet Therapy is Associated with a Better Prognosis for Patients with Hepatitis B Virus-Related Hepatocellular Carcinoma after Liver Resection

Background Recurrence of hepatocellular carcinoma (HCC) with unsatisfactory survival is common after surgical resection. Antiplatelet therapy with aspirin or clopidogrel was recently shown to prevent hepatic carcinogenesis in a murine model, but its effect in humans had not been clarified. This stud...

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Published in:Annals of surgical oncology 2016-12, Vol.23 (Suppl 5), p.874-883
Main Authors: Lee, Pei-Chang, Yeh, Chiu-Mei, Hu, Yu-Wen, Chen, Chun-Chia, Liu, Chia-Jen, Su, Chien-Wei, Huo, Teh-Ia, Huang, Yi-Hsiang, Chao, Yee, Chen, Tzeng-Ji, Lin, Han-Chieh, Wu, Jaw-Ching
Format: Article
Language:English
Subjects:
Adult
Aged
Aspirin - therapeutic use
Carcinoma, Hepatocellular - mortality
Carcinoma, Hepatocellular - surgery
Carcinoma, Hepatocellular - virology
Disease-Free Survival
Female
Gastrointestinal Hemorrhage - chemically induced
Gastrointestinal Hemorrhage - epidemiology
Hepatectomy
Hepatitis B virus
Hepatitis B, Chronic - complications
Hepatobiliary Tumors
Humans
Kaplan-Meier Estimate
Liver Neoplasms - mortality
Liver Neoplasms - surgery
Liver Neoplasms - virology
Male
Medicine
Medicine & Public Health
Middle Aged
Neoplasm Recurrence, Local - epidemiology
Oncology
Platelet Aggregation Inhibitors - adverse effects
Platelet Aggregation Inhibitors - therapeutic use
Proportional Hazards Models
Risk Factors
Surgery
Surgical Oncology
Survival Rate
Taiwan - epidemiology
Ticlopidine - analogs & derivatives
Ticlopidine - therapeutic use
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Summary:Background Recurrence of hepatocellular carcinoma (HCC) with unsatisfactory survival is common after surgical resection. Antiplatelet therapy with aspirin or clopidogrel was recently shown to prevent hepatic carcinogenesis in a murine model, but its effect in humans had not been clarified. This study aimed to investigate the association between antiplatelet therapy and the outcomes for patients with hepatitis B virus (HBV)-related HCC after liver resection. Methods By analyzing data from the Taiwan National Health Insurance Research Database, 9461 HBV-related HCC patients who had undergone liver resection between January 1997 and December 2011 were identified. After one-to-four matching by sex, age, and propensity score, 442 patients with antiplatelet therapy and 1768 patients without antiplatelet therapy were enrolled for the analysis. The Kaplan–Meier method and modified Cox proportional hazards models were used for survival and multivariable, stratified analyses. Results Recurrence-free survival and overall survival after resection surgery were significantly better after 5 years in the treated cohort than in the untreated cohort (52.8 vs 47.9 %; p  = 0.021 and 80.3 vs 65.4 %; p  
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-016-5520-9