REGULAR CONTENT
Final ID
492
Type
Original Scientific Research-Oral or Pos
Authors
F Boas1, E Ziv1, H Yarmohammadi1, K Brown1, J Erinjeri1, C Sofocleous1, J Harding1, S Solomon1
Institutions
1Memorial Sloan Kettering Cancer Center, New York, NY
Purpose
To determine if home medications taken at the time of liver tumor embolization or ablation affect survival.
Materials & Methods
An IRB-approved retrospective review was performed of 2002 liver tumor embolization, radioembolization, and ablation procedures on 1068 patients from June 2009 to April 2016. For each patient, the following information was recorded: pathology, HCC stage (AJCC), NET grade, initial locoregional therapy, survival after initial locoregional therapy, Child Pugh score, ECOG score, age-corrected Charlson comorbidity score, and home medications taken at the time of locoregional therapy. Kaplan Meier survival curves were calculated for patients taking 29 common medications or medication classes (including both prescription and non-prescription medications), which the patient was taking for reasons unrelated to their primary cancer diagnosis. Kaplan Meier curves were compared using the log-rank test.
Results
The most common pathologies were: hepatocellular carcinoma (HCC; 30%), colorectal liver metastases (22%), and neuroendocrine tumor (NET; 20%). The initial procedure was transarterial embolization in 62% of patients, radioembolization in 12%, and ablation in 26%. The following medications were associated with improved survival when taken at the time of embolization of HCC: aspirin (p=0.0008), proton pump inhibitors (p=0.004), beta blockers (p=0.007), and NSAIDs excluding aspirin (p=0.009). Beta blockers were associated with improved survival when taken at the time of ablation of colorectal liver metastases (p=0.02). For these medications, there was no significant difference in HCC stage, Child Pugh score, ECOG score, or Charlson comorbidity score for patients taking versus not taking the medication. Using a p-value cutoff of 0.0017 (Bonferroni correction for multiple comparisons), the association between aspirin and improved survival after embolization for HCC remains statistically significant.
Conclusions
Aspirin is associated with significantly improved survival when taken at the time of embolization for HCC. Several other medications show some promise as adjuvants to locoregional therapy.
Final ID
492
Type
Original Scientific Research-Oral or Pos
Authors
F Boas1, E Ziv1, H Yarmohammadi1, K Brown1, J Erinjeri1, C Sofocleous1, J Harding1, S Solomon1
Institutions
1Memorial Sloan Kettering Cancer Center, New York, NY
Purpose
To determine if home medications taken at the time of liver tumor embolization or ablation affect survival.
Materials & Methods
An IRB-approved retrospective review was performed of 2002 liver tumor embolization, radioembolization, and ablation procedures on 1068 patients from June 2009 to April 2016. For each patient, the following information was recorded: pathology, HCC stage (AJCC), NET grade, initial locoregional therapy, survival after initial locoregional therapy, Child Pugh score, ECOG score, age-corrected Charlson comorbidity score, and home medications taken at the time of locoregional therapy. Kaplan Meier survival curves were calculated for patients taking 29 common medications or medication classes (including both prescription and non-prescription medications), which the patient was taking for reasons unrelated to their primary cancer diagnosis. Kaplan Meier curves were compared using the log-rank test.
Results
The most common pathologies were: hepatocellular carcinoma (HCC; 30%), colorectal liver metastases (22%), and neuroendocrine tumor (NET; 20%). The initial procedure was transarterial embolization in 62% of patients, radioembolization in 12%, and ablation in 26%. The following medications were associated with improved survival when taken at the time of embolization of HCC: aspirin (p=0.0008), proton pump inhibitors (p=0.004), beta blockers (p=0.007), and NSAIDs excluding aspirin (p=0.009). Beta blockers were associated with improved survival when taken at the time of ablation of colorectal liver metastases (p=0.02). For these medications, there was no significant difference in HCC stage, Child Pugh score, ECOG score, or Charlson comorbidity score for patients taking versus not taking the medication. Using a p-value cutoff of 0.0017 (Bonferroni correction for multiple comparisons), the association between aspirin and improved survival after embolization for HCC remains statistically significant.
Conclusions
Aspirin is associated with significantly improved survival when taken at the time of embolization for HCC. Several other medications show some promise as adjuvants to locoregional therapy.