Evidence mapPaperPMID 39295976Full record

ArticleWorld journal of transplantation2024

Statin, aspirin and metformin use and risk of hepatocellular carcinoma related outcomes following liver transplantation: A retrospective study.

William Chung, Kevin Wong, Noel Ravindranayagam, Lauren Tang, Josephine Grace, Darren Wong, Danny Con, Marie Sinclair, Avik Majumdar, Numan Kutaiba and 5 more

Abstract read
In one paragraph

Article in World journal of transplantation, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

William ChungDepartment of Gastroenterology, Austin Health, Heidelberg 3084, Victoria, Australia.
Kevin WongDepartment of Gastroenterology, Austin Health, Heidelberg 3084, Victoria, Australia.
Noel RavindranayagamDepartment of Gastroenterology, Austin Health, Heidelberg 3084, Victoria, Australia.
Lauren TangDepartment of Gastroenterology, Austin Health, Heidelberg 3084, Victoria, Australia.
Josephine GraceDepartment of Gastroenterology, Austin Health, Heidelberg 3084, Victoria, Australia.
Darren WongDepartment of Gastroenterology, Austin Health, Heidelberg 3084, Victoria, Australia.
Danny ConDepartment of Gastroenterology, Austin Health, Heidelberg 3084, Victoria, Australia.
Marie SinclairDepartment of Gastroenterology, Austin Health, Heidelberg 3084, Victoria, Australia.
Avik MajumdarDepartment of Gastroenterology, Austin Health, Heidelberg 3084, Victoria, Australia.
Numan KutaibaDepartment of Radiology, Austin Health, Heidelberg 3084, Victoria, Australia.
Samuel HuiDepartment of Gastroenterology, Austin Health, Heidelberg 3084, Victoria, Australia.
Paul GowDepartment of Gastroenterology, Austin Health, Heidelberg 3084, Victoria, Australia.
Vijayaragavan MuralidharanDepartment of Surgery, University of Melbourne, Austin Health, Heidelberg 3048, Victoria, Australia.
Alexander DobrovicDepartment of Surgery, Beacon Laboratory, Austin Precinct, The University of Melbourne, Austin Hospital, Heidelberg 3048, Victoria, Australia.
Adam TestroDepartment of Gastroenterology, Austin Health, Heidelberg 3084, Victoria, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLiver transplantation (LT) is a potentially curative therapy for patients with hepatocellular carcinoma (HCC). HCC-recurrence following LT is associated with reduced survival. There is increasing interest in chemoprophylaxis to improve HCC-related outcomes post-LT.

aimTo investigate whether there is any benefit for the use of drugs with proposed chemoprophylactic properties against HCC, and patient outcomes following LT.

methodsThis was a retrospective study of adult patients who received Deceased Donor LT for HCC from 2005-2022, from a single Australian centre. Drug use was defined as statin, aspirin or metformin therapy for ≥ 29 days, within 24 months post-LT. A cox proportional-hazards model with time-dependent covariates was used for survival analysis. Outcome measures were the composite-endpoint of HCC-recurrence and all-cause mortality, HCC-recurrence and HCC-related mortality. Sensitivity analysis was performed to account for immortality time bias and statin dosing.

resultsThree hundred and five patients were included in this study, with 253 (82.95%) males with a median age of 58.90 years. Aetiologies of liver disease were 150 (49.18%) hepatitis C, 73 (23.93%) hepatitis B (HBV) and 33 (10.82%) non-alcoholic fatty liver disease (NAFLD). 56 (18.36%) took statins, 51 (16.72%) aspirin and 50 (16.39%) metformin. During a median follow-up time of 59.90 months, 34 (11.15%) developed HCC-recurrence, 48 (15.74%) died, 17 (5.57%) from HCC-related mortality. Statin, aspirin or metformin use was not associated with statistically significant differences in the composite endpoint of HCC-recurrence or all-cause mortality [hazard ratio (HR): 1.16, 95%CI: 0.58-2.30; HR: 1.21, 95%CI: 0.28-5.27; HR: 0.61, 95%CI: 0.27-1.36], HCC-recurrence (HR: 0.52, 95%CI: 0.20-1.35; HR: 0.51, 95%CI: 0.14-1.93; HR 1.00, 95%CI: 0.37-2.72), or HCC-related mortality (HR: 0.32, 95%CI: 0.033-3.09; HR: 0.71, 95%CI: 0.14-3.73; HR: 1.57, 95%CI: 0.61-4.04) respectively. Statin dosing was not associated with statistically significant differences in HCC-related outcomes.

conclusionStatin, metformin or aspirin use was not associated with improved HCC-related outcomes post-LT, in a largely historical cohort of Australian patients with a low proportion of NAFLD. Further prospective, multicentre studies are required to clarify any potential benefit of these drugs to improve HCC-related outcomes.

Indexed as

AspirinHepatocellular carcinomaHMG-Co-A reductaseLiver transplantationMammalian target of rapamycinMetforminStatinsTransplant oncology

Identifiers

PMID39295976
PMCPMC11317854

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.