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. 2020 Apr 3;12(4):874.
doi: 10.3390/cancers12040874.

Statin Use Decreases the Incidence of Hepatocellular Carcinoma: An Updated Meta-Analysis

Antonio Facciorusso  1 , Mohamed A Abd El Aziz  2 , Siddharth Singh  3 , Sara Pusceddu  4 , Massimo Milione  4 , Luca Giacomelli  5   6 , Rodolfo Sacco  1
Affiliations

Statin Use Decreases the Incidence of Hepatocellular Carcinoma: An Updated Meta-Analysis

Antonio Facciorusso et al. Cancers (Basel). .

Abstract

Statins can decrease hepatocellular carcinoma (HCC) occurrence, but the magnitude and the predictors of these effects remain unclear. This meta-analysis provides a pooled estimate of the impact of statin use on HCC occurrence. Pooled effects were calculated using a random-effects model by means of the DerSimonian and Laird test. Primary endpoint was the time-dependent correlation between statin use and HCC incidence expressed as hazard ratio (HR), both crude and adjusted. The crude and adjusted odds ratios (OR) for HCC occurrence between statin users and non-users were analyzed. Twenty-five studies with 1,925,964 patients were included. Crude OR for HCC incidence was 0.59 (95% CI: 0.47-0.74), confirmed in adjusted analysis (OR: 0.74, 95% CI: 0.70-0.78). Adjusted HR was 0.73 (95% CI: 0.69-0.76). This effect was more pronounced in HBV patients (HR: 0.46, 95% CI: 0.36-0.60) and with a cumulative daily dose beyond 365 (HR: 0.27, 95% CI: 0.11-0.67). Lipophilic statins were associated with reduced HCC incidence (HR: 0.49, 95% CI: 0.39-0.62). Atorvastatin determined the greater magnitude of effect (HR: 0.43, 95% CI: 0.28-0.65). This meta-analysis demonstrates the beneficial chemopreventive effect of statins against HCC occurrence. This effect is dose-dependent and more pronounced with lipophilic statins.

Keywords: HCC; cancer; cirrhosis; hazard ratio; survival.

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Conflict of interest statement

None of the authors have any relevant financial disclosures.

Figures

Figure 1
Figure 1
Flow chart of the search strategy conducted in this meta-analysis.
Figure 2
Figure 2
Odds ratio for HCC occurrence in the comparison between statin users and non-users: (A) crude odds ratio; and (B) adjusted odds ratio.
Figure 3
Figure 3
Hazard ratio for HCC occurrence in the comparison between statin users and non-users. (A) Crude HR. (B) Adjusted HR.
See this image and copyright information in PMC

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