The use of statins may reduce the risk of death in patients with hepatocellular cancer by 30%, a retrospective study of 639 patients suggests.
Median overall survival from 2000 until 2011 was 22 months for the 68 statin users, significantly longer than the 18-month median survival for the 571 non-statin users, Dr. Young Kwang Chae and his associates reported in a poster presentation at a meeting on gastrointestinal cancers sponsored by the American Society of Clinical Oncology (ASCO). The study won a Merit Award at the meeting.
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The 30% improvement in survival with statin use also was seen in subgroups of patients who received systemic or local therapy. The benefits were still seen after controlling for the effects of age, sex, race, cancer staging, liver cirrhosis, cancer treatment, alcohol use, diabetes, and hepatitis C or hepatitis B infection.
The findings warrant a large prospective study to validate the results, said Dr. Chae, a fellow at the University of Texas M.D. Anderson Cancer Center, Houston.
Some preclinical evidence supports the idea that statins may have antitumor activity, and several observational studies have reported inverse associations between statin use and the incidence of hepatocellular cancer.
In the current study – the largest so far to look at the effects of statins on hepatocellular cancer outcomes – median survival for all 639 patients with hepatocellular cancer was 19 months. Approximately 11% of patients reported statin use.
Statin users were significantly less likely to have underlying liver cirrhosis (48%) compared with non-statin users (64%). Only patients free of cirrhosis showed a significant, 30% decrease in mortality with statin use. The survival benefit of statins was not seen in patients with cirrhosis.
Among patients without cirrhosis, the median survival was 32 months for statin users and 22 months for non-statin users. Among patients with cirrhosis, the median survival was 18 months for statin users and 19 months for non-statin users.
There were some other significant differences between statin users and nonusers. Statin users were more likely to be aged 50 years or older (97%) compared with nonusers (86%), and more likely to have diabetes (52% and 32%, respectively).
Patients not using statins were more likely to have a history of hepatitis C or B infection (50%) compared with statin users (29%). A history of hepatitis, however, did not affect the association between statin use and improved mortality, Dr. Chae reported.
Fifty-three percent of patients in each group were treated with chemotherapy for the hepatocellular cancer. Statin users were more likely to undergo surgery (24%) or to receive local treatment (28%) compared with non-statin users, 18% of whom had surgery and 15% of whom had local treatment. The remaining option – no treatment – was more likely in non-statin users than in patients on statins (15% vs. 9%, respectively). Patients could receive more than one category of treatment.
Patients had a mean age of 63 years; 73% were male, and 66% were white. Seventy-one percent of the hepatocellular cancers were diagnosed at tumor stage III or IV.
The meeting was cosponsored by ASCO, the American Gastroenterological Association Institute, the American Society for Radiation Oncology, and the Society of Surgical Oncology.
Dr. Chae reported having no financial disclosures.
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