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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 5/2016

01-12-2016 | Hepatobiliary Tumors

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

Authors: Pei-Chang Lee, MD, Chiu-Mei Yeh, MS, Yu-Wen Hu, MD, Chun-Chia Chen, MD, Chia-Jen Liu, MD, PhD, Chien-Wei Su, MD, PhD, Teh-Ia Huo, MD, Yi-Hsiang Huang, MD, PhD, Yee Chao, MD, Tzeng-Ji Chen, MD, PhD, Han-Chieh Lin, MD, Jaw-Ching Wu, MD, PhD

Published in: Annals of Surgical Oncology | Special Issue 5/2016

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Abstract

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 < 0.001, respectively). Besides, antiplatelet therapy reduced the risk of HCC recurrence (hazard ratio [HR] 0.73; p < 0.001) and overall mortality (HR 0.57; p < 0.001) in the multivariable analysis. However, antiplatelet use significantly increased the risk of upper gastrointestinal bleeding (odds ratio [OR] 1.91; p < 0.001).

Conclusions

Use of aspirin or clopidogrel was associated with better recurrence-free survival and overall survival among patients with HBV-related HCC after liver resection. However, these agents should be used with caution due to the adverse effects of upper gastrointestinal bleeding.
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Metadata
Title
Antiplatelet Therapy is Associated with a Better Prognosis for Patients with Hepatitis B Virus-Related Hepatocellular Carcinoma after Liver Resection
Authors
Pei-Chang Lee, MD
Chiu-Mei Yeh, MS
Yu-Wen Hu, MD
Chun-Chia Chen, MD
Chia-Jen Liu, MD, PhD
Chien-Wei Su, MD, PhD
Teh-Ia Huo, MD
Yi-Hsiang Huang, MD, PhD
Yee Chao, MD
Tzeng-Ji Chen, MD, PhD
Han-Chieh Lin, MD
Jaw-Ching Wu, MD, PhD
Publication date
01-12-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue Special Issue 5/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5520-9

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