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抗血小板药物对肝移植术后肝细胞癌复发的影响

Antiplatelet Drugs on the Recurrence of Hepatocellular Carcinoma after Liver Transplantation.

作者信息

Choi Mun Chae, Min Eun-Ki, Lee Jae Geun, Joo Dong Jin, Kim Myoung Soo, Kim Deok-Gie

机构信息

Department of Surgery, The Research Institute for Transplantation, Yonsei University College, Seoul 03722, Korea.

出版信息

Cancers (Basel). 2022 Oct 29;14(21):5329. doi: 10.3390/cancers14215329.

DOI:10.3390/cancers14215329
PMID:36358749
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9654602/
Abstract

Previous studies reported suppressive effects of antiplatelet agents on hepatocellular carcinoma (HCC); however, this has never been assessed in patients who underwent liver transplantation (LT). This retrospective observational study used data from LT recipients with pre-transplant HCC in a single tertiary hospital. The study population was divided into two groups according to the use of antiplatelet agents for >90 days within the study period (377 antiplatelet groups versus 91 non-antiplatelet groups). Matched groups containing 79 patients in each group were also compared regarding HCC-recurrence and HCC-related mortality, which were analyzed by treating non-HCC death as a competing risk. In Kaplan−Meier analyses of the matched cohort, the 5-year cumulative incidences of HCC recurrence and HCC-specific death were similar between the antiplatelet (p = 0.876) and non-antiplatelet groups (p = 0.701). All-cause and non-HCC deaths were also similar between the two groups (p = 0.867 and p = 0.413, respectively). In multivariable analyses of the entire cohort, antiplatelet use was not associated with HCC recurrence (hazard ratio [HR] 1.37, p = 0.300) or HCC-specific death (HR 1.54, p = 0.310). Therefore, unlike the usual setting with liver disease, antiplatelet therapy did not affect HCC recurrence or HCC-specific mortality when used after LT.

摘要

既往研究报道了抗血小板药物对肝细胞癌(HCC)的抑制作用;然而,尚未在接受肝移植(LT)的患者中对此进行评估。这项回顾性观察性研究使用了一家三级医院中LT受者的移植前HCC数据。根据研究期间使用抗血小板药物超过90天的情况,将研究人群分为两组(抗血小板组377例与非抗血小板组91例)。还比较了每组各含79例患者的匹配组的HCC复发情况和HCC相关死亡率,并将非HCC死亡作为竞争风险进行分析。在匹配队列的Kaplan-Meier分析中,抗血小板组(p = 0.876)和非抗血小板组(p = 0.701)的HCC复发和HCC特异性死亡的5年累积发生率相似。两组的全因死亡和非HCC死亡情况也相似(分别为p = 0.867和p = 0.413)。在整个队列的多变量分析中,使用抗血小板药物与HCC复发(风险比[HR] 1.37,p = 0.300)或HCC特异性死亡(HR 1.54,p = 0.310)无关。因此,与肝病的常见情况不同,LT后使用抗血小板治疗不会影响HCC复发或HCC特异性死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8fc/9654602/99a00a525b1d/cancers-14-05329-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8fc/9654602/99a00a525b1d/cancers-14-05329-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8fc/9654602/99a00a525b1d/cancers-14-05329-g001.jpg

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Cancers (Basel). 2020 Oct 31;12(11):3215. doi: 10.3390/cancers12113215.
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mTOR Inhibition Is Most Beneficial After Liver Transplantation for Hepatocellular Carcinoma in Patients With Active Tumors.
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Liver transplantation in hepatocellular carcinoma after tumour downstaging (XXL): a randomised, controlled, phase 2b/3 trial.肝癌肿瘤降期后行肝移植的研究(XXL):一项随机、对照、2b/3 期临床试验。
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