Source

1Liver Unit, Jean Verdier Hospital.

Abstract

Propranolol bears antioxidant anti-inflammatory ,anti-angiogenic properties and anti-tumoral effects and therefore is potentially active in the prevention of hepatocellular carcinoma (HCC) .We retrospectively assessed the impact of propranolol treatment on HCC occurrence in a cohort of 291 patients with compensated viral C (HCV) cirrhosis, prospectively screened for HCC. Among them, 93 (50 male, mean age 59.5 ± 12, platelet count:111 ± 53 ) developed esophageal varices (OV) or had OV at inclusion and 198 ( 111 male, mean age 55.8 ± 13, platelet count :137 ± 59) did not. Among patients with OV, 50 received treatment with propranolol. During a median follow-up of 54 months (32, 82), 61 patients developed a HCC. The 3 and 5-year HCC incidence was 4% - 4% and 10%-20% in patients treated and non-treated with propranolol respectively (Gray test p=0.03). In multivariate analysis, propranolol treatment was associated with a low risk of HCC occurrence (HR=0.25 CI 0.09-0.65, p=0.004), and was the only predictive factor of HCC occurrence in patients with OV (HR=0.16 CI 0.06-0.45, p=0.0005). The benefit of propranolol was further supported by propensity scores analyses.This retrospective long term observational study suggests that propranolol treatment may decrease HCC occurrence in patients with HCV cirrhosis.