The association between proton-pump inhibitor use and recurrence of hepatocellular carcinoma after hepatectomy.

IF 3.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastroenterology and Hepatology Pub Date : 2024-06-12 DOI:10.1111/jgh.16640

Chun-Ting Ho, Chia-Chu Fu, Elise Chia-Hui Tan, Wei-Yu Kao, Pei-Chang Lee, Yi-Hsiang Huang, Teh-Ia Huo, Ming-Chih Hou, Jaw-Ching Wu, Chien-Wei Su

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Abstract

Background and aim: The association between long-term proton-pump inhibitors (PPIs) use and malignancies had long been discussed, but it still lacks consensus. Our study investigated the association between PPI use and hepatocellular carcinoma (HCC) recurrence following curative surgery.

Methods: We retrospectively enrolled 6037 patients with HCC who underwent hepatectomy. Patients were divided into four groups according to their PPI usage. (non-users: < 28 cumulative defined daily dose [cDDD]; short-term users: 28-89 cDDD; mid-term users: 90-179 cDDD, and long-term users: ≥ 180 cDDD, respectively). Recurrence-free survival (RFS) and overall survival (OS) were analyzed using Kaplan-Meier method and Cox proportional hazard models.

Results: Among the 6037 HCC patients, 2043 (33.84%) were PPI users. PPI users demonstrated better median RFS (3.10 years, interquartile range [IQR] 1.49-5.01) compared with non-users (2.73 years, IQR 1.20-4.74; with an adjusted hazard ratio [aHR] of 0.57, 95% confidence interval [CI] 0.44-0.74, P < 0.001). When considering the cumulative dosage of PPI, only long-term PPI users had significant lower risk of HCC recurrence than non-PPI group (adj-HR: 0.50; 95% CI: 0.35-0.70; P < 0.001). Moreover, the impact of long-term PPIs use on improving RFS was significant in most of the subgroup analysis, except in patients with advanced tumor stages, with non-cirrhosis, or with a history of chronic kidney disease. However, there were no significant differences in median OS between PPI users and non-users (4.23 years, IQR 2.73-5.86 vs 4.04 years, IQR 2.51-5.82, P = 0.369).

Conclusion: Long-term PPI use (≥ 180 cDDD) may be associated with a better RFS in HCC patients after hepatectomy.

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使用质子泵抑制剂与肝切除术后肝细胞癌复发之间的关系。

背景和目的：长期使用质子泵抑制剂（PPIs）与恶性肿瘤之间的关系讨论已久，但仍缺乏共识。我们的研究调查了质子泵抑制剂的使用与肝细胞癌（HCC）治愈性手术后复发之间的关系：我们回顾性地纳入了 6037 名接受肝切除术的 HCC 患者。根据使用 PPI 的情况将患者分为四组。(不使用PPI组）和使用PPI组（使用PPI组）：结果在 6037 例 HCC 患者中，有 2043 例（33.84%）使用 PPI。与不使用 PPI 的患者（2.73 年，IQR 1.20-4.74；调整后危险比 [aHR] 0.57，95% 置信区间 [CI] 0.44-0.74，P 结论）相比，使用 PPI 的患者的中位 RFS 更好（3.10 年，四分位数间距 [IQR] 1.49-5.01）：长期使用 PPI（≥ 180 cDDD）可能与肝切除术后 HCC 患者较好的 RFS 相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Gastroenterology and Hepatology 医学-胃肠肝病学

CiteScore

7.90

自引率

2.40%

发文量

326

审稿时长

2.3 months

期刊介绍： Journal of Gastroenterology and Hepatology is produced 12 times per year and publishes peer-reviewed original papers, reviews and editorials concerned with clinical practice and research in the fields of hepatology, gastroenterology and endoscopy. Papers cover the medical, radiological, pathological, biochemical, physiological and historical aspects of the subject areas. All submitted papers are reviewed by at least two referees expert in the field of the submitted paper.

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