Department of Oncologic Pathology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts.
Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Clin Gastroenterol Hepatol. 2018 Aug;16(8):1300-1306.e3. doi: 10.1016/j.cgh.2018.02.022. Epub 2018 Feb 21.
BACKGROUND & AIMS: Statin medications, most commonly prescribed to reduce lipid levels and prevent cardiovascular disease, may be associated with longer survival times of patients with cancer. However, the association of statins with outcomes of patients with pancreatic adenocarcinoma is not clear.
We analyzed the association of statin use before a diagnosis of pancreatic cancer with survival times of 648 participants in the Nurses' Health Study and Health Professionals Follow-up Study who were diagnosed with pancreatic adenocarcinoma from 2000 through 2013. We estimated hazard ratios (HRs) for overall mortality using Cox proportional hazards models with adjustment for potential confounders. We assessed the temporal association between prediagnosis statin use and cancer survival by 2-year lag periods to account for a possible latency period between statin use and cancer survival.
Regular statin use before diagnosis of pancreatic cancer was associated with modestly prolonged survival compared with nonregular use (adjusted HR, 0.82; 95% CI, 0.69-0.97; P = .02). A 1-month longer median survival was observed in regular statin users compared with nonregular users. Regular statin use within the 2 years prior to cancer diagnosis was most strongly associated with longer survival. We observed no statistically significant effect modification by smoking status, body mass index, diabetes, or cancer stage (all P > .53). Regular statin use before diagnosis was similarly associated with survival in the Nurses' Health Study (HR, 0.79; 95% CI, 0.64-0.97) and Health Professionals Follow-up Study (HR, 0.86; 95% CI, 0.63-1.15).
Regular statin use before diagnosis of pancreatic cancer was associated with modest increases in survival times in 2 large prospective cohort studies.
他汀类药物通常用于降低血脂水平和预防心血管疾病，可能与癌症患者的生存时间延长有关。然而，他汀类药物与胰腺腺癌患者结局的相关性尚不清楚。
我们分析了护士健康研究和健康专业人员随访研究中的 648 名参与者，这些参与者在 2000 年至 2013 年间被诊断患有胰腺腺癌，在诊断为胰腺癌之前使用他汀类药物与生存时间之间的关系。我们使用 Cox 比例风险模型估计了全因死亡率的风险比（HR），并对潜在混杂因素进行了调整。我们通过 2 年的滞后期评估了诊断前他汀类药物使用与癌症生存之间的时间关联，以考虑他汀类药物使用与癌症生存之间可能存在的潜伏期。
与非定期使用相比，诊断前常规使用他汀类药物与生存时间适度延长相关（调整后的 HR，0.82；95%CI，0.69-0.97；P=0.02）。定期使用他汀类药物的患者比非定期使用的患者中位生存期延长了 1 个月。在癌症诊断前 2 年内定期使用他汀类药物与生存时间延长的相关性最强。我们没有观察到吸烟状况、体重指数、糖尿病或癌症分期的统计学显著的效应修饰作用（均 P>0.53）。在护士健康研究（HR，0.79；95%CI，0.64-0.97）和健康专业人员随访研究（HR，0.86；95%CI，0.63-1.15）中，诊断前定期使用他汀类药物与生存也有类似的相关性。
在 2 项大型前瞻性队列研究中，诊断为胰腺腺癌之前定期使用他汀类药物与生存时间适度增加相关。
