Xie Weimin, Ning Li, Huang Yuenan, Liu Yan, Zhang Wen, Hu Yingchao, Lang Jinghe, Yang Jiaxin
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of General Surgery, The Second Affiliated Hospital, Harbin Medical University, Harbin, China.
Oncotarget. 2017 Jun 20;8(25):41508-41517. doi: 10.18632/oncotarget.17242.
Previous studies investigating the association between statin use and survival outcomes in gynecologic cancers have yielded controversial results. We conducted a systematic review and meta-analysis to evaluate the association based on available evidence. We searched the databases of the Cochrane Central Register of Controlled Trials (CENTRAL), Embase, and PubMed from inception to January 2017. Studies that evaluated the association between statin use and survival outcomes in gynecologic cancers were included. Pooled hazard ratios (HRs) for overall survival, disease-specific survival and progression-free survival were calculated using a fixed-effects model. A total of 11 studies involving more than 6,920 patients with endocrine-related gynecologic cancers were identified. In a meta-analysis of 7 studies involving 5,449 patients with endocrine-related gynecologic cancers, statin use was linked to improved overall survival (HR, 0.71; 95% confidence interval [CI], 0.63 to 0.80) without significant heterogeneity (I2 = 33.3%). Statin users also had improved disease-specific survival (3 studies, HR, 0.72; 95% CI, 0.58 to 0.90, I2 = 35.1%) and progression-free survival (3 studies, HR, 0.68; 95% CI, 0.49 to 0.93, I2 = 33.6%) in endocrine-related gynecologic cancers. Our findings support that statin use has potential survival benefits for patients with endocrine-related gynecologic cancers. Further large-scale prospective studies are required to validate our findings.
以往关于他汀类药物使用与妇科癌症生存结局之间关联的研究结果存在争议。我们进行了一项系统评价和荟萃分析，以根据现有证据评估这种关联。我们检索了Cochrane对照试验中央注册库（CENTRAL）、Embase和PubMed数据库，检索时间从各数据库建库至2017年1月。纳入评估他汀类药物使用与妇科癌症生存结局之间关联的研究。采用固定效应模型计算总生存、疾病特异性生存和无进展生存的合并风险比（HR）。共识别出11项研究，涉及6920多名内分泌相关妇科癌症患者。在一项对7项研究（涉及5449名内分泌相关妇科癌症患者）的荟萃分析中，使用他汀类药物与改善总生存相关（HR，0.71；95%置信区间[CI]，0.63至0.80），且无显著异质性（I2 = 33.3%）。在内分泌相关妇科癌症中，他汀类药物使用者的疾病特异性生存（3项研究，HR，0.72；95%CI，0.58至0.90，I2 = 35.1%）和无进展生存（3项研究，HR，0.68；95%CI，0.49至0.93，I2 = 33.6%）也得到改善。我们的研究结果支持他汀类药物使用对内分泌相关妇科癌症患者具有潜在的生存益处。需要进一步的大规模前瞻性研究来验证我们的研究结果。
