Division of Hematology/Oncology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.
School of Public Health, National Defense Medical Center, Taipei, Taiwan, Republic of China.
PLoS One. 2019 May 24;14(5):e0216828. doi: 10.1371/journal.pone.0216828. eCollection 2019.
Beta-blockers can reduce recurrence, metastasis, and mortality in various cancers. In this study, we investigated the effect of propranolol, a non-selective beta-blocker on overall survival (OS) in unresectable/metastatic hepatocellular carcinoma (HCC) and on recurrence-free survival (RFS) in resectable, curable HCC.
Data were retrieved from the Taiwan National Health Insurance Research Database between January 2000 and December 2013. Propranolol users (for >1 year) and non-propranolol users were matched using a 1:2 propensity score in both cohorts.
The unresectable/metastatic HCC cohort comprised 1,560 propranolol users and 3,120 non-propranolol users (control group). On multivariate Cox regression analysis of HCC mortality, propranolol significantly reduced the mortality risk by 22% (hazard ratio [HR] = 0.78, 95% confidence interval [CI] 0.72-0.84, P <0.001). On stratified Cox regression analysis, propranolol also reduced the mortality risk in HCC patients with hepatitis B (HR = 0.92, 95% CI 0.85-0.99, P = 0.045), hepatitis C (HR = 0.85, 95% CI = 0.78-0.92, P = 0.001), liver cirrhosis (HR = 0.78, 95% CI = 0.72-0.85, P <0.001), and diabetes mellitus (HR = 0.87, 95% CI = 0.81-0.94, P = 0.008). The resectable, curable HCC cohort comprised 289 propranolol users and 578 non-propranolol users (control group), but there was no significant difference in RFS (P = 0.762) between propranolol and non-propranolol users.
This study revealed that propranolol could improve OS in unresectable/metastatic HCC.
β受体阻滞剂可降低多种癌症的复发、转移和死亡率。本研究旨在探讨非选择性β受体阻滞剂普萘洛尔对不可切除/转移性肝细胞癌（HCC）患者总生存（OS）的影响，以及对可切除、可治愈 HCC 患者无复发生存（RFS）的影响。
数据来自 2000 年 1 月至 2013 年 12 月台湾全民健康保险研究数据库。在两个队列中，使用 1:2 倾向评分匹配普萘洛尔使用者（>1 年）和非普萘洛尔使用者。
不可切除/转移性 HCC 队列包括 1560 名普萘洛尔使用者和 3120 名非普萘洛尔使用者（对照组）。多变量 Cox 回归分析 HCC 死亡率显示，普萘洛尔可显著降低 22%的死亡风险（风险比[HR] = 0.78，95%置信区间[CI] 0.72-0.84，P <0.001）。分层 Cox 回归分析显示，普萘洛尔还可降低乙型肝炎（HR = 0.92，95%CI 0.85-0.99，P = 0.045）、丙型肝炎（HR = 0.85，95%CI = 0.78-0.92，P = 0.001）、肝硬化（HR = 0.78，95%CI = 0.72-0.85，P <0.001）和糖尿病（HR = 0.87，95%CI = 0.81-0.94，P = 0.008）患者的 HCC 死亡率。可切除、可治愈 HCC 队列包括 289 名普萘洛尔使用者和 578 名非普萘洛尔使用者（对照组），但普萘洛尔组与非普萘洛尔组之间 RFS 无显著差异（P = 0.762）。
本研究表明，普萘洛尔可改善不可切除/转移性 HCC 患者的 OS。
