Association of 5-hydroxytryptamine 3 receptor antagonists with prognosis in patients with advanced hepatocellular carcinoma: A propensity score-matched study
- 1Department of Infectious Diseases, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
- 2Department of Rehabilitation, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
Abstract
5-Hydroxytryptamine and its receptor are involved in hepatocarcinogenesis. This study investigated the effects of 5-hydroxytryptamine 3 receptor antagonists (5-HT3RAs) on the prognosis of patients with advanced hepatocellular carcinoma (HCC). Patients with advanced HCC who received best supportive care were analyzed. Overall survival (OS) between 5-HT3RA users and nonusers was compared. Propensity score matching (PSM) was used to balance variables. Factors associated with prognosis were identified by Cox regression. A total of 1141 patients with advanced HCC were included and 102 of them received 5-HT3RAs. 5-HT3RA treatment was significantly associated with reduced mortality [hazard ratio (HR) = 0.690; 95% confidence interval (CI): 0.546–0.871; p = 0.002]. After 1:2 PSM (n = 89 and n = 161 in 5-HT3RA user and nonuser groups, respectively), 5-HT3RA treatment remained significantly associated with reduced mortality (HR = 0.615; 95% CI: 0.457–0.829; p = 0.001). Subgroup analysis of hepatitis B virus-associated HCC patients yielded similar findings. Subgroup analysis of 5-HT3RAs also yielded similar findings, showing that the 5-year OS was significantly higher in tropisetron users than nonusers (23.7% vs. 10.9%, p = 0.004) after PSM. The use of ondansetron (HR = 0.603; 95% CI: 0.365–0.995; p = 0.048) or tropisetron (HR = 0.477; 95% CI: 0.299–0.759; p = 0.002) was independent factor associated with improved prognosis after PSM. Taken together, this study shows that the use of 5-HT3RAs is associated with improved OS and the use of ondansetron or tropisetron was independently associated with a better prognosis in patients with advanced HCC, indicating a favorable effect of 5-HT3RAs on HCC patients.
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BibTeX
@article{zhang2026association,
title = {{Association of 5-hydroxytryptamine 3 receptor antagonists with prognosis in patients with advanced hepatocellular carcinoma: A propensity score-matched study}},
author = {Xiaoge Zhang and Xiaoyun Wang and Na Li and Qunying Han and Zhengwen Liu},
journal = {PLOS One},
year = {2026},
month = oct,
doi = {10.1371/journal.pone.0359798},
url = {https://doi.org/10.1371/journal.pone.0359798},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Association of 5-hydroxytryptamine 3 receptor antagonists with prognosis in patients with advanced hepatocellular carcinoma: A propensity score-matched study
AU - Xiaoge Zhang
AU - Xiaoyun Wang
AU - Na Li
AU - Qunying Han
AU - Zhengwen Liu
PY - 2026
DA - 2026/10/08
JO - PLOS One
DO - 10.1371/journal.pone.0359798
UR - https://doi.org/10.1371/journal.pone.0359798
AB - 5-Hydroxytryptamine and its receptor are involved in hepatocarcinogenesis. This study investigated the effects of 5-hydroxytryptamine 3 receptor antagonists (5-HT3RAs) on the prognosis of patients with advanced hepatocellular carcinoma (HCC). Patients with advanced HCC who received best supportive care were analyzed. Overall survival (OS) between 5-HT3RA users and nonusers was compared. Propensity score matching (PSM) was used to balance variables. Factors associated with prognosis were identified by Cox regression. A total of 1141 patients with advanced HCC were included and 102 of them received 5-HT3RAs. 5-HT3RA treatment was significantly associated with reduced mortality [hazard ratio (HR) = 0.690; 95% confidence interval (CI): 0.546–0.871; p = 0.002]. After 1:2 PSM (n = 89 and n = 161 in 5-HT3RA user and nonuser groups, respectively), 5-HT3RA treatment remained significantly associated with reduced mortality (HR = 0.615; 95% CI: 0.457–0.829; p = 0.001). Subgroup analysis of hepatitis B virus-associated HCC patients yielded similar findings. Subgroup analysis of 5-HT3RAs also yielded similar findings, showing that the 5-year OS was significantly higher in tropisetron users than nonusers (23.7% vs. 10.9%, p = 0.004) after PSM. The use of ondansetron (HR = 0.603; 95% CI: 0.365–0.995; p = 0.048) or tropisetron (HR = 0.477; 95% CI: 0.299–0.759; p = 0.002) was independent factor associated with improved prognosis after PSM. Taken together, this study shows that the use of 5-HT3RAs is associated with improved OS and the use of ondansetron or tropisetron was independently associated with a better prognosis in patients with advanced HCC, indicating a favorable effect of 5-HT3RAs on HCC patients.
SN - 1932-6203
ER -