Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington.
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington.
Cancer Epidemiol Biomarkers Prev. 2019 Jul;28(7):1127-1133. doi: 10.1158/1055-9965.EPI-18-1194. Epub 2019 May 7.
It has been suggested that the likelihood of survival among women with ovarian cancer could be increased by postdiagnosis statin use. This study examines the potential association between postdiagnosis statin use and cancer-specific mortality among women with ovarian cancer.
This cohort study used SEER-Medicare data on women ≥66 years of age diagnosed with ovarian cancer during 2007 to 2012 who were enrolled in Medicare parts A, B, and D during the year after diagnosis. Statin use was defined as two or more fills for a statin during the year after diagnosis. Ovarian cancer-specific death was assessed starting 1 year after diagnosis. Marginal structural Cox models were used, adjusting for the inverse probability of treatment weighting and censoring weighting. Treatment weights and censoring weights were calculated using logistic regression models with -defined covariates.
Among 2,195 women with ovarian cancer, 489 (22%) used statins within 1 year after their diagnosis. Over a mean follow-up of 2.2 years, 796 (36%) women died from ovarian cancer. The adjusted HR for ovarian cancer mortality comparing statin users to nonusers was 0.74 (95% confidence interval, 0.61-0.91).
Findings from this and prior work suggest statin use following a diagnosis with ovarian cancer is associated with a lower risk of cancer death.
Because, in most women, statin administration has limited side effects, a randomized trial of statins among patients with ovarian cancer may be warranted.
有研究表明，卵巢癌患者在确诊后使用他汀类药物可能会提高生存率。本研究旨在探讨卵巢癌患者确诊后使用他汀类药物与癌症特异性死亡率之间的潜在关联。
本队列研究利用 SEER-Medicare 数据库，纳入了在 2007 年至 2012 年期间被诊断为卵巢癌且年龄≥66 岁、在确诊后一年内参加了 Medicare 计划 A、B 和 D 的女性患者。他汀类药物的使用定义为在确诊后一年内开具了两种或以上他汀类药物的处方。从确诊后 1 年开始评估卵巢癌特异性死亡。使用逆概率治疗加权和删失加权调整边际结构 Cox 模型。使用基于定义好的协变量的逻辑回归模型计算治疗权重和删失权重。
在 2195 名患有卵巢癌的女性中，有 489 名（22%）在确诊后 1 年内使用了他汀类药物。在平均 2.2 年的随访中，有 796 名（36%）女性死于卵巢癌。与未使用者相比，他汀类药物使用者的卵巢癌死亡率调整后的 HR 为 0.74（95%置信区间，0.61-0.91）。
本研究与既往研究结果表明，卵巢癌确诊后使用他汀类药物与癌症死亡风险降低相关。
鉴于他汀类药物在大多数女性中的应用副作用有限，因此针对卵巢癌患者开展他汀类药物的随机临床试验可能是合理的。
