Department of Clinical and Experimental Medicine, Linköping University, 58183 Linköping, Sweden; Department of Radiology, and Department of Medical and Health Sciences, Linköping University, 58185 Linköping, Sweden.
Department of Oncology, and Department of Clinical and Experimental Medicine, Linköping University, 58185 Linköping, Sweden.
J Geriatr Oncol. 2019 Sep;10(5):690-697. doi: 10.1016/j.jgo.2019.01.011. Epub 2019 Jan 26.
Increasing evidence suggests that statins may have antitumor effects but their role in rectal cancer appears inconclusive. The aim of this study was to investigate whether statins may have an impact on survival of older and younger patients with rectal cancer.
This study included 238 patients ≥70 years and 227 patients <70 years old, from the Southeast Health Care Region of Sweden, who were diagnosed with rectal adenocarcinoma between 2004 and 2013.
In the older group (n = 238), statin use at the time of diagnosis was related to better cancer-specific survival (CSS) and overall survival (OS), compared to non-use (CSS: Hazard Ratio (HR), 0.37; 95% CI, 0.19-0.72; P = .003; OS: HR, 0.62; 95% CI, 0.39-0.96; P = .032). In the older group with stages I-III disease (n = 199), statin use was associated with better disease-free survival (DFS) compared to non use (HR, 0.18; 95% CI, 0.06-0.59; P = .005). The improvement of CSS, OS and DFS remained significant after adjusting for potential confounders. In the older group with stage III disease, statin users had better CSS and DFS compared to non-users (log rank P = .043; log-rank P = .028, respectively). In the older group with short course radiotherapy, statin use was related to better CSS (log-rank P = .032). No such association was present in the younger group.
Statin use was related to improved survival in older patients with rectal cancer. This observation is important given the low cost and safety of statins as a drug.
越来越多的证据表明他汀类药物可能具有抗肿瘤作用，但它们在直肠癌中的作用尚不确定。本研究旨在探讨他汀类药物是否会影响老年和年轻直肠癌患者的生存。
本研究纳入了瑞典东南医疗区 2004 年至 2013 年间诊断为直肠腺癌的 238 名年龄≥70 岁和 227 名年龄<70 岁的患者。
在老年组（n=238）中，与未使用他汀类药物相比，诊断时使用他汀类药物与更好的癌症特异性生存（CSS）和总生存（OS）相关（CSS：风险比（HR），0.37；95%CI，0.19-0.72；P=0.003；OS：HR，0.62；95%CI，0.39-0.96；P=0.032）。在 I-III 期疾病的老年组（n=199）中，与未使用他汀类药物相比，使用他汀类药物与更好的无病生存（DFS）相关（HR，0.18；95%CI，0.06-0.59；P=0.005）。调整潜在混杂因素后，CSS、OS 和 DFS 的改善仍然具有统计学意义。在 III 期疾病的老年组中，与未使用者相比，他汀类药物使用者的 CSS 和 DFS 更好（对数秩检验 P=0.043；对数秩检验 P=0.028）。在年轻组中则未观察到这种关联。
他汀类药物的使用与老年直肠癌患者的生存改善有关。鉴于他汀类药物作为一种药物的低成本和安全性，这一观察结果很重要。
