Nonsteroidal anti-inflammatory drugs are associated with reduced risk of early hepatocellular carcinoma recurrence after curative liver resection: A nationwide cohort study

Chun Chieh Yeh, Jaw Town Lin, Long Bin Jeng, Hsiu J. Ho, Horng Ren Yang, Ming Shiang Wu, Ken N. Kuo, Chun Ying Wu*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

44 Scopus citations

Abstract

Purpose: The efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs) in reducing the risk of various de novo cancers has been reported; however, its role in reducing hepatocellular carcinoma (HCC) recurrence after liver resection still remains unknown. Methods: We have conducted a nationwide cohort study by recruiting all patients with a newly diagnosedHCCwho had received curative liver resection as their initial treatment. The use of NSAIDs and the risk of early HCC recurrence have been examined by multivariate and stratified analyses. To avoid immortal time bias, the use of NSAIDs has been treated as a timedependent variable in Cox proportional hazard ratio models. Results: Between January 1997 and December 2010, a total of 15,574 HCC patientswho had received liver resectionwere enrolled in this study. The 1-, 3-, and 5-year overall survival rates were 90.4%, 73.2%, and 59.8%, respectively. The 1-, 3-, and 5-year disease-free survival rates were 80.5%, 59.4%, and 50.2%, respectively. NSAID use (hazard ratio, 0.81; 95% confidence interval, 0.73-0.90) and minor liver resection (hazard ratio, 0.83; 95% confidence interval, 0.78-0.89)were independently associated with a reduced risk of early HCC recurrence after liver resection. In the stratified analyses, NSAID usage was universally associated with reduced risks in most subgroups, particularly for those aged younger than 65 years, male, with underlying diabetes mellitus and receiving major liver resection. Conclusions: The use of NSAIDs can be associated with a reduced risk of early HCC recurrence within 2 years after curative liver resection, regardless of patients' age, extent of liver resection, viral hepatitis status, underlying diabetes, and liver cirrhosis.

Original languageEnglish
Pages (from-to)521-526
Number of pages6
JournalAnnals of Surgery
Volume261
Issue number3
DOIs
StatePublished - 2015
Externally publishedYes

Bibliographical note

Publisher Copyright:
Copyright © 2014 Wolters Kluwer Health, Inc. All rights reserved.

Keywords

  • Chemoprevention
  • Early recurrence
  • HCC
  • Liver resection
  • Nonsteroidal anti-inflammatory drugs

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