{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T17:55:35Z","timestamp":1791482135342,"version":"4.3.4"},"reference-count":48,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>\n                    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\u20130.871;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.002]. After 1:2 PSM (n\u2009=\u200989 and n\u2009=\u2009161 in 5-HT3RA user and nonuser groups, respectively), 5-HT3RA treatment remained significantly associated with reduced mortality (HR\u2009=\u20090.615; 95% CI: 0.457\u20130.829;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.001). 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%\n                    <jats:italic>vs.<\/jats:italic>\n                    10.9%,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.004) after PSM. The use of ondansetron (HR\u2009=\u20090.603; 95% CI: 0.365\u20130.995;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.048) or tropisetron (HR\u2009=\u20090.477; 95% CI: 0.299\u20130.759;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.002) 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.\n                  <\/jats:p>","DOI":"10.1371\/journal.pone.0359798","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T17:25:53Z","timestamp":1791480353000},"page":"e0359798","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of 5-hydroxytryptamine 3 receptor antagonists with prognosis in patients with advanced hepatocellular carcinoma: A propensity score-matched study"],"prefix":"10.1371","volume":"21","author":[{"given":"Xiaoge","family":"Zhang","sequence":"first","affiliation":[{"name":"First Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi\u2019an, Shaanxi, People\u2019s Republic of China"],"department":["Department of Infectious Diseases"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyun","family":"Wang","sequence":"additional","affiliation":[{"name":"First Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi\u2019an, Shaanxi, People\u2019s Republic of China"],"department":["Department of Infectious Diseases"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Li","sequence":"additional","affiliation":[{"name":"First Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi\u2019an, Shaanxi, People\u2019s Republic of China"],"department":["Department of Rehabilitation"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qunying","family":"Han","sequence":"additional","affiliation":[{"name":"First Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi\u2019an, Shaanxi, People\u2019s Republic of China"],"department":["Department of Infectious Diseases"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3965-4947","authenticated-orcid":true,"given":"Zhengwen","family":"Liu","sequence":"additional","affiliation":[{"name":"First Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi\u2019an, Shaanxi, People\u2019s Republic of China"],"department":["Department of Infectious Diseases"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"issue":"3","key":"pone.0359798.ref001","first-page":"229","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"F Bray","year":"2024","journal-title":"CA Cancer J Clin"},{"issue":"1","key":"pone.0359798.ref002","first-page":"47","article-title":"Cancer incidence and mortality in China, 2022","volume":"4","author":"B Han","year":"2024","journal-title":"J Natl Cancer Cent"},{"issue":"6","key":"pone.0359798.ref003","doi-asserted-by":"crossref","first-page":"1922","DOI":"10.1097\/HEP.0000000000000466","article-title":"AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma","volume":"78","author":"AG Singal","year":"2023","journal-title":"Hepatology"},{"issue":"1","key":"pone.0359798.ref004","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1124\/pr.118.015552","article-title":"International Union of Basic and Clinical Pharmacology. 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