By acting on both liver stem cells and endothelial cells, statins might specifically affect some of the main molecular pathways which are implicated in the pathogenesis and biological features of HCC, such as inhibition of cell proliferation, induction of apoptosis and inhibition of angiogenesis. Such effects, which may be relatively selective in cancer cells, result from either inhibited synthesis of cholesterol or pleiotropic activity and may be observed also in advanced primary/metastatic disease. Experimental studies and preclinical observations suggest that statins might prevent/inhibit the development of HCC and portal hypertension. Evidence in humans, however, is much more conflicting, limited and mostly observational. Therefore, there is a strong need for randomized controlled trials for the chemoprevention of HCC in categories of individuals with chronic liver disease at a high risk for HCC. In particular, cirrhotic individuals already submitted to treatment for HCC with liver resection or ablation represent the chief candidates to be recruited in such future studies.
J Gastroenterol Hepatol. 2012;27(11):1654-1664. © 2012 Blackwell Publishing