Data from Statin Use and Survival with Early-Stage Hepatocellular Carcinoma

Background: Limited clinical and epidemiologic data suggest that statins may improve the outcomes of hepatocellular carcinoma (HCC), which has poor prognosis.

Methods: We identified 1,036 stage I or II HCC patients, diagnosed between 2007 and 2009, through the linked Surveillance, Epidemiology, and End Results (SEER) Program and Medicare claims database. Of these, 363 patients were using statin either at the time of their HCC diagnosis or afterwards. We conducted multivariable Cox regression analysis to estimate the time-dependent effect of statin on survival. The analysis included age, sex, resection, transarterial chemoembolization, transplantation, cirrhosis, cardiovascular disease, diabetes, dyslipidemia, and hepatitis B and C.

Results: Over a median follow-up time of 21 months, 584 HCC patients died. Statin users had a longer median survival compared with nonusers: 23.9 versus 18.9 months (P = 0.047). However, after accounting for immortal time bias and confounding, statin use was not associated with survival (HR, 0.98; 95% confidence interval, 0.80–1.20). The associations did not vary by hepatitis C or intensity of statin use.

Conclusion: Statin treatment after HCC diagnosis was not associated with survival in elderly patients with stage I/II disease.

Impact: Our study of nationally representative elderly patients with stage I or II HCC in the United States shows that statin treatment does not improve survival with liver cancer. Cancer Epidemiol Biomarkers Prev; 25(4); 686–92. ©2016 AACR.