The anticancer effect of statins is drawing attention. However, it is unclear whether statin use reduces the risk of hepatocellular carcinoma (HCC) recurrence in patients who undergo liver transplantation (LT) for HCC. Consecutive patients who underwent LT for HCC between 1995 and 2019 were enrolled. The effects of statins on HCC recurrence and mortality were compared between statin user and statin nonuser groups. We performed the analyses in a variety of ways, including inverse probability treatment weighting (IPTW) methods to balance any confounders and the landmark method to avoid immortal time bias. A total of 430 patients were enrolled, among whom 323 (75.1%) were statin nonusers and 107 (24.9%) were statin users. During a median of 64.9 months (IQR, 26.1-122.6 months) of follow-up, 79 patients (18.4%) had HCC recurrence and 111 (25.8%) died. Among those who died, 53 (47.7%) were identified as HCC-related mortalities. Statin use was a predictor of HCC recurrence (adjusted hazard ratio [HR], 0.3; 95% confidence interval [CI], 0.1-0.6; P = 0.002), all-cause mortality (adjusted HR, 0.3; 95% CI, 0.2-0.5; P < 0.001), and HCC-related mortality (adjusted HR, 0.4; 95% CI, 0.2-0.9; P = 0.03). The effects of statin use on clinical outcomes were also identified through IPTW analysis. There was a dose-dependent relationship between statin use and HCC recurrence. The anticancer effect of statins on HCC recurrence was consistently significant across multivariable-stratified and sensitivity analyses. Statin use significantly reduced the risk of HCC recurrence and improved the survival of patients who underwent LT for HCC.

中文翻译：

---

他汀类药物对肝细胞癌肝移植患者的抗癌作用

他汀类药物的抗癌作用备受关注。然而，尚不清楚他汀类药物的使用是否会降低因 HCC 而接受肝移植 (LT) 的患者的肝细胞癌 (HCC) 复发风险。连续入组了在 1995 年至 2019 年间因 HCC 而接受 LT 的患者。在他汀类药物使用者和非他汀类药物使用者组之间比较了他汀类药物对 HCC 复发和死亡率的影响。我们以多种方式进行分析，包括用于平衡任何混杂因素的逆概率处理加权 (IPTW) 方法和用于避免不朽时间偏差的地标方法。共纳入 430 例患者，其中 323 例（75.1%）未使用他汀类药物，107 例（24.9%）使用他汀类药物。在中位 64.9 个月（IQR，26.1-122.6 个月）的随访期间，79 名患者 (18.4%) 出现 HCC 复发，111 名 (25.8%) 患者死亡。在死亡者中，53 人 (47.7%) 被确定为与 HCC 相关的死亡。他汀类药物的使用是 HCC 复发的预测因素（调整后的风险比 [HR]，0.3；95% 置信区间 [CI]，0.1-0.6；P  = 0.002）、全因死亡率（调整后的 HR，0.3；95% CI，0.2-0.5；P  < 0.001）和 HCC 相关死亡率（调整后的 HR，0.4；95% CI，0.2-0.9；P  = 0.03 ). 还通过 IPTW 分析确定了他汀类药物使用对临床结果的影响。他汀类药物的使用与 HCC 复发之间存在剂量依赖关系。在多变量分层和敏感性分析中，他汀类药物对 HCC 复发的抗癌作用始终显着。他汀类药物的使用显着降低了 HCC 复发的风险，并改善了接受 LT 治疗的 HCC 患者的生存期。