The role of antiplatelet therapies on incidence and mortality of hepatocellular carcinoma

Quirino Lai; Nicoletta De Matthaeis; Michele Finotti; Giovanni Galati; Giuseppe Marrone; Fabio Melandro; Filomena Morisco; Daniele Nicolini; Riccardo Pravisani; Edoardo G Giannini; Associazione Italiana per lo Studio del Fegato (AISF) HCC Special Interest Group

doi:10.1111/eci.13870

The role of antiplatelet therapies on incidence and mortality of hepatocellular carcinoma

Eur J Clin Invest. 2023 Jan;53(1):e13870. doi: 10.1111/eci.13870. Epub 2022 Sep 16.

Collaborators

Associazione Italiana per lo Studio del Fegato (AISF) HCC Special Interest Group:
Aglitti A, Aliberti C, Baccarani U, Bhoori S, Borzio M, Brancaccio G, Burra P, Cabibbo G, Casadei Gardini A, Carrai P, Cillo U, Conti F, Cucchetti A, D'Ambrosio R, Dell'Unto C, Di Costanzo Gg, Di Sandro S, Foschi Fg, Fucilli F, Gambato M, Gasbarrini A, Giuliante F, Ghinolfi D, Grieco A, Gruttaduria S, Guarino M, Kostandini A, Iavarone M, Lenci I, Levi Sandri Gb, Losito F, Lupo Lg, Manzia Tm, Mazzocato S, Mescoli C, Miele L, Muley M, Persico M, Plaz Torres Mc, Pompili M, Ponziani Fr, Rapaccini Gl, Rendina M, Renzulli M, Rossi M, Rreka E, Russo Fp, Sacco R, Sangiovanni A, Sessa A, Simonetti N, Sposito C, Tortora R, Trevisani F, Viganò L, Viganò M, Villa E, Vincenzi V, Violi P, Vitale A

Affiliations

¹ General Surgery and Organ Transplantation Unit, AOU Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
² Department of Medical and Surgical Sciences, Fondazione Policlinico Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.
³ 4th Surgery Unit, Regional Hospital Treviso, DISCOG, University of Padua, Padua, Italy.
⁴ Unit of Clinical Medicine and Hepatology, University Campus Bio-Medico, Rome, Italy.
⁵ Hepatobiliary surgery and liver transplantation, University of Pisa Medical School Hospital, Pisa, Italy.
⁶ Department of Clinical Medicine and Surgery, Gastroenterology and Hepatology Unit, University of Naples "Federico II", Napoli, Italy.
⁷ Unit of Hepatobiliary Surgery and Transplantation, Polytechnic University of Marche, Azienda Ospedaliero-Universitaria "Ospedali Riuniti" Torrette, Ancona, Italy.
⁸ Liver-Kidney Transplantation Unit, Department of Medicine, University of Udine, Udine, Italy.
⁹ Gastroenterology Unit, Department of Internal Medicine, IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy.

Abstract

Aim: To evaluate the impact of antiplatelet therapy (APT)on the incidence of hepatocellular carcinoma (HCC) and mortality following its treatment.

Methods: A systematic literature search was performed using PubMed and Cochrane Central Register of Controlled Trials Databases. Two HCC clinical settings were explored: (i) incidence, and (ii) death after any HCC treatment. Odds ratios (OR) and 95% confidence intervals (95%CI) were calculated to compare the pooled data between patients who received or did not receive APT.

Results: A total of 20 studies were identified, of whom 15 focused on HCC incidence, including 2,685,009 patients, and five on post-treatment death, including 3281 patients. APT was associated with an overall reduced risk of HCC incidence (OR: 0.63; 95%CI = 0.51-0.79; p < 0.001) as well as of post-treatment mortality (OR: 0.54; 95%CI = 0.35-0.83; p = 0.006).

Conclusions: Current data suggest that APT correlated with higher HCC incidence and poor overall survival following tumour treatment.

Keywords: aspirin; clopidogrel; incidence; occurrence; survival.

MeSH terms

Carcinoma, Hepatocellular* / epidemiology
Humans
Incidence
Liver Neoplasms* / epidemiology