Renin-angiotensin inhibitors were associated with improving outcomes of hepatocellular carcinoma with primary hypertension after hepatectomy

Abstract

Background: The activation of the renin-angiotensin system (RAS) promotes tumor progression. In this study, we aimed to assess whether RAS inhibitors (RASIs) could improve the outcome of hepatocellular carcinoma (HCC) patients with primary hypertension after curative liver resection.Methods: Data on 387 consecutive patients with primary hypertension who underwent curative liver resection for HCC were reviewed. The study population was divided into two groups based on the type of anti-hypertensive medications: the RASI group (patients using RASIs) and the non-RASI group (patients using other anti-hypertensive drugs but not RASIs). Kaplan-Meier curves, log-rank tests and cox proportional hazards regression models were used to analyze time to recurrence (TTR) and overall survival (OS).Results: There were 144 (37.2%) patients in RASI group and 243 (62.8%) in non-RASI group. The preoperative clinicopathological features were comparable between the two groups. Kaplan-Meier curves demonstrated HCC patients with RASIs had a longer TTR and OS than the patients with non-RASIs (both P<0.001). On multivariate analysis, RASIs administration was identified as an independent prognostic factor for TTR [hazard ratio (HR) =0.52, 95% confidence interval (CI), 0.38-0.70, P<0.001] and OS (HR =0.50, 95% CI, 0.34-0.74, P<0.001). Patients in the RASI group had lower rates of extrahepatic metastases than patients in the non-RASI group (2.8% vs. 7.8%, P<0.042).Conclusions: Targeting the RAS was associated with a reduced risk of recurrence, decreased rate of extrahepatic metastases and prolonged survival of HCC patients with primary hypertension after curative liver resection.

System analysis based on the cuproptosis-related genes identifies LIPT1 as a novel therapy target for liver hepatocellular carcinoma

“…Interestingly, previous studies suggest that RAS is involved in the formation and development of LIHC [ 56 , 58 ]. The Ang II / Ang II type 1 receptor (AT1R) axis can promote tumor progression and metastasis, while the ACE2/Ang- (1 − 7)/MasR axis plays an opposite role [ 55 , 59 , 60 ]. Accordingly, some studies have indicated that AT1R is highly expressed in LIHC samples [ 61 , 62 ].…”

Irbesartan inhibits metastasis by interrupting the adherence of tumor cell to endothelial cell induced by angiotensin II in hepatocellular carcinoma

“…An increasing (6 clinical reports) supporting studies have confirmed that Ang II inhibitors can improve the prognosis of HCC patients by enhancing the efficacy of sorafenib, reducing the risk of recurrence and prolonging survival after curative treatments (10,(18)(19)(20)(21)(22). We also reported that the use of Ang II inhibitors was associated with a reduced risk of disease recurrence, prolonged survival and a decreased rate of extrahepatic metastases in HCC patients after curative resection (23).…”

“…The times to recurrence and overall survival were used as endpoint events. Follow-up and survival time calculations were performed as outlined in our previous report (23).…”

The Importance of Metabolic Syndrome Status for the Risk of Non-Viral Hepatocellular Carcinoma: A Nationwide Population-Based Study

“…Recently, Feng et al. reported that renin-angiotensin inhibitor was associated with longer time-to-recurrence and overall survival of HCC patients with essential hypertension after hepatectomy ( 44 ). Arterial hypertension might play a fundamental role in liver injury and progression of hepatic fibrosis leading to increased risk of HCC development.…”