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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 United+European+Gastroenterol+J
2017 ; 5
(7
): 987-996
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Use of inhibitors of the renin-angiotensin system is associated with longer
survival in patients with hepatocellular carcinoma
#MMPMID29163965
Pinter M
; Weinmann A
; Wörns MA
; Hucke F
; Bota S
; Marquardt JU
; Duda DG
; Jain RK
; Galle PR
; Trauner M
; Peck-Radosavljevic M
; Sieghart W
United European Gastroenterol J
2017[Nov]; 5
(7
): 987-996
PMID29163965
show ga
BACKGROUND: Inhibition of the renin-angiotensin system (RAS) was associated with
longer survival in patients with different solid malignancies. OBJECTIVE: The
objective of this study was to investigate the effect of RAS inhibitor (RASi)
treatment (angiotensin-converting enzyme inhibitors or angiotensin-II-receptor
blockers) on survival of patients with hepatocellular carcinoma (HCC). METHODS:
Patients diagnosed with HCC and Child-Pugh A between 1992 and 2013 who received
sorafenib, experimental therapy, or best supportive care were eligible for the
Vienna cohort. The Mainz cohort included patients with HCC and Child-Pugh A who
received sorafenib treatment between 2007 and 2016. The association between RASi
and overall survival (OS) was evaluated in univariate and multivariate analyses.
RESULTS: In the Vienna cohort, 43 of 156 patients received RASi for hypertension.
RASi treatment was associated with longer OS (11.9 vs. 6.8 months (mo);
p?=?0.014) and remained a significant prognostic factor upon multivariate
analysis (HR?=?0.6; 95% CI 0.4-0.9; p?=?0.011). In subgroup analysis, patients
treated with sorafenib plus RASi had better median OS (19.5?mo) compared to those
treated with either sorafenib (10.9?mo) or RASi (9.7?mo) alone (p?=?0.043). The
beneficial effect of RASi on survival was confirmed in the Mainz cohort (n?=?76).
CONCLUSION: RAS inhibition is associated with longer survival in HCC patients
with Child-Pugh class A.
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