ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2017
Estrogen Replacement Reduces Risk and Increases Survival Times of Women With Hepatocellular Carcinoma.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 67 papers, 3 of them syntheses that pooled it.
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Who cites it
67 citing papers in PubMed, 3 syntheses or guidelines pooled it, 128 citations in OpenAlex.
- Molecular mechanisms of sex hormones in Hepatocellular Carcinoma: a systematic review.Molecular biology reports · 2025Pooled it
- Oral contraceptive use and risk of liver cancer: a population-based study, systematic review, and meta-analysis.The Lancet. Oncology · 2025Pooled it
- Intricate roles of estrogen and estrogen receptors in digestive system cancers: a systematic review.Cancer biology & medicine · 2024Pooled it
- Nomograms to predict the long-time prognosis in patients with alpha-fetoprotein negative hepatocellular carcinoma following radical resection.Cancer medicine · 2020Trial
- Sex Differences in Mortality Among Patients With Hepatocellular Carcinoma.JAMA network open · 2026Article
- Intratumoral but not circulating estradiol predicts postoperative survival in men with hepatocellular carcinoma.Discover oncology · 2026Article
- Menopausal hormone therapy and risk of liver cancer in a Swedish population-based cohort study.Journal of the National Cancer Institute · 2026Article
- Repeated measurements of alpha fetoprotein and fibrosis-4 predict long term hepatocellular carcinoma and mortality risks after antiviral therapy.Infectious medicine · 2026Article
- Sex differences in cancer incidence persist across race and ethnicity.Biology of sex differences · 2026Article
- Gastrointestinal cancers in women: The role of sex hormones.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026Review
- Article
- Sex and gender disparities in hepatocellular carcinoma: insights into risk, diagnosis, and therapeutic outcomes.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025Review
- Comprehensive phosphoproteomic profiling reveals sex-specific regulatory mechanisms in HrasG12V-driven hepatocarcinogenesis.Cancer cell international · 2025Article
- Article
- Sex based relative expression of estrogen receptors and tumor necrosis factor-alpha in liver affects hepatitis C virus viral pathogenesis.World journal of gastroenterology · 2025Article
- Life's essential 8 and specific cancer risk and mortality in men and women: a population-based cohort analysis of 332,417 United Kingdom participants.BMC cancer · 2025Article
- Estrogen receptor α suppresses hepatocellular carcinoma by restricting M2 macrophage infiltration through the YAP-CCL2 axis.BMC cancer · 2025Article
- Shifting mortality patterns of primary liver cancer in the United States: a 20-year analysis of disparities.Frontiers in public health · 2025Article
- Advances in Tumor Microenvironment and Immunotherapeutic Strategies for Hepatocellular Carcinoma.Oncology research · 2025Review
- Novel Stemness-Associated Scores: Enhancing Predictions of Hepatocellular Carcinoma Prognosis and Tumor Immune Microenvironment.Oncology research · 2025Article
7 more citing papers are in PubMed but not listed here.
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Authors and funding
24 authors at 6 institutions in 3 countries.
Funding
Abstract
BACKGROUND &
aimsEnvironmental factors have been identified that affect risk of hepatocellular carcinoma (HCC), but little is known about the effects of sex hormones on liver cancer development or outcome. The authors investigated whether menopause hormone therapy (MHT) affects risk, age at onset, or outcome of HCC.
methodsWe performed a case-control study of 234 female patients treated for HCC at a tertiary medical center and with 282 healthy women (controls) from January 1, 2004 through May 31, 2015. We collected detailed information on environmental exposures, ages of menarche and menopause, hysterectomies, and uses of birth control and MHT. We performed multivariable logistic and Cox regression analyses to determine the independent effects of factors associated with women on risk and clinical outcome in HCC. The primary outcomes were effect of MHT on HCC risk, the relationship between MHT with hepatitis virus infection on HCC development, and effect of MHT on age at HCC onset or survival after diagnosis of HCC.
resultsThe estimated adjusted odds ratio (AOR) for HCC in women who ever used estrogen was 0.53 (95% confidence interval [CI], 0.32-0.88). This association was supported by the older age of HCC onset among estrogen users (mean, 64.5 ± 0.9 years) vs nonusers (mean 59.2 ± 1.1 years; P = .001) and the reduced risk of HCC among long-term users (more than 5 years) (AOR, 0.36; 95% CI, 0.20-0.63). Users of estrogen also had a reduced risk for hepatitis-associated HCC: AOR for users, 4.37 (95% CI, 1.67-11.44) vs AOR for nonusers, 17.60 (95% CI, 3.88-79.83). Estrogen use reduced risk of death from HCC (hazard ratio, 0.55; 95% CI, 0.40-0.77; P = .01). Median overall survival times were 33.5 months for estrogen users (95% CI, 25.7-41.3 months) and 24.1 months for nonusers (95% CI, 19.02-29.30 months; P = .008).
conclusionIn a case-control study of women with HCC vs female control subjects at a single center, we associated use of estrogen MHT with reduced risk of HCC and increased overall survival times of patients with HCC. Further studies are needed to determine the benefits of estrogen therapy for women and patients with HCC, and effects of tumor expression of estrogen receptor.
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