Vogel Tilley Jenkins, Goodman Marc T, Li Andrew J, Jeon Christie Y
Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States.
Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States.
Gynecol Oncol. 2017 Aug;146(2):340-345. doi: 10.1016/j.ygyno.2017.05.009. Epub 2017 Jun 7.
Observational studies suggest that statin therapy for cardio-protection is associated with improved survival in cancer patients. We sought to evaluate the impact of statin treatment on ovarian cancer survival in a nationally representative elderly population.
The linked Surveillance, Epidemiology, and End Results (SEER) registries and Medicare claims data on patients diagnosed with epithelial ovarian cancer in 2007-2009 were used to extract data on statin prescription fills, population characteristics, primary treatment, comorbidity and survival. Cox regression models were used to examine the association between statin treatment and overall survival.
Among the 1431 ovarian cancer patients who underwent surgical resection, 609 (42.6%) filled prescriptions for statin. The majority of statin-users (89%) were prescribed a lipophilic formulation. Mean overall survival among statin-users was 32.3months compared to 28.8months for non-users (p<0.0001). A 34% reduction in death was associated with statin therapy, independent of age, race, neighborhood median household income, stage, platinum therapy and comorbid conditions (HR=0.66, 95% CI 0.55-0.81). Improved overall survival with statin use was observed for both serous (HR=0.69, 95% CI 0.54-0.87) and non-serous (HR=0.63, 95% CI 0.44-0.90) histologies. When statin treatment was categorized by lipophilicity and intensity, a significant survival benefit was limited to lipophilic statin users and those who took statins of moderate intensity.
This SEER-Medicare analysis demonstrates improvement in overall survival with lipophilic statin use after surgery in elderly patients with epithelial ovarian cancer. A clinical trial to evaluate the impact of statin treatment in ovarian cancer survival is warranted.
观察性研究表明,他汀类药物用于心脏保护治疗可提高癌症患者的生存率。我们试图评估他汀类药物治疗对全国具有代表性的老年人群卵巢癌生存率的影响。
利用2007 - 2009年期间与监测、流行病学和最终结果(SEER)登记处相关联的医疗保险报销数据,提取被诊断为上皮性卵巢癌患者的他汀类药物处方配药、人口特征、初始治疗、合并症和生存数据。采用Cox回归模型来检验他汀类药物治疗与总生存率之间的关联。
在1431例行手术切除的卵巢癌患者中,609例(42.6%)开具了他汀类药物处方。大多数他汀类药物使用者(89%)被开具了亲脂性制剂。他汀类药物使用者的平均总生存期为32.3个月,而非使用者为28.8个月(p<0.0001)。他汀类药物治疗与死亡风险降低34%相关,且独立于年龄、种族、邻里家庭收入中位数、分期、铂类治疗和合并症(HR = 0.66,95% CI 0.55 - 0.81)。对于浆液性(HR = 0.69,95% CI 0.54 - 0.87)和非浆液性(HR = 0.63,95% CI 0.44 - 0.90)组织学类型,使用他汀类药物均观察到总生存期改善。当根据亲脂性和强度对他汀类药物治疗进行分类时,显著的生存获益仅限于亲脂性他汀类药物使用者和服用中等强度他汀类药物的患者。
这项SEER - 医疗保险分析表明,老年上皮性卵巢癌患者术后使用亲脂性他汀类药物可改善总生存期。有必要进行一项临床试验来评估他汀类药物治疗对卵巢癌生存率的影响。