Yu-Yun Shao1, Chih-Hung Hsu1, Kun-Huei Yeh1, Ho-Min Chen2, Yi-Chun Yeh3, Chiu-Lin Lai2, Zhong-Zhe Lin4, Ann-Lii Cheng5, Mei-Shu Lai6. 1. Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan. 2. Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan. 3. Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan. 4. Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan. 5. Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: alcheng@ntu.edu.tw. 6. Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Taiwan Cancer Registry, Taipei, Taiwan. Electronic address: mslai@cph.ntu.edu.tw.
Abstract
BACKGROUND: Statins are widely used for hyperlipidemia control and might also exhibit anticancer properties. This study explored whether statin use is associated with the prognosis of curatively resected colorectal cancer (CRC). MATERIALS AND METHODS: Using data from the Taiwan Cancer Registry, we established a population-based cohort of patients who received curative surgery for stage I, II, or III CRC. Data related to prescription medications and comorbidities were retrieved from the database of the National Health Insurance program of Taiwan. Statin users were defined as patients who had used statins within 1 year before their cancer diagnosis. Univariate and multivariate analyses were used to compare cancer-specific survival (CSS) and overall survival (OS) between statin users and patients who had never used statins (never users). In the multivariate analysis, we used propensity scores to adjust for age, sex, diagnosis year, physician visits, hospitalization, conjunctive medications, and comorbidities. RESULTS: A total of 17,115 patients were enrolled; 2145 (13%) of these patients were statin users, and 14,970 (87%) were never users. After adjusting for other potential prognostic factors, statin use was an independent predictor for longer CSS (hazard ratio [HR], 0.77; 95% confidence interval [CI], 0.68-0.88; P < .001) and OS (HR, 0.82; 95% CI, 0.74-0.92; P < .001). These associations were consistent across subgroups, including sexes, tumor stages, and age cohorts, and in CRC patients who suffered from diabetes and hypertension. CONCLUSION: Statin use is associated with an improved prognosis of curatively resected CRC.
BACKGROUND: Statins are widely used for hyperlipidemia control and might also exhibit anticancer properties. This study explored whether statin use is associated with the prognosis of curatively resected colorectal cancer (CRC). MATERIALS AND METHODS: Using data from the Taiwan Cancer Registry, we established a population-based cohort of patients who received curative surgery for stage I, II, or III CRC. Data related to prescription medications and comorbidities were retrieved from the database of the National Health Insurance program of Taiwan. Statin users were defined as patients who had used statins within 1 year before their cancer diagnosis. Univariate and multivariate analyses were used to compare cancer-specific survival (CSS) and overall survival (OS) between statin users and patients who had never used statins (never users). In the multivariate analysis, we used propensity scores to adjust for age, sex, diagnosis year, physician visits, hospitalization, conjunctive medications, and comorbidities. RESULTS: A total of 17,115 patients were enrolled; 2145 (13%) of these patients were statin users, and 14,970 (87%) were never users. After adjusting for other potential prognostic factors, statin use was an independent predictor for longer CSS (hazard ratio [HR], 0.77; 95% confidence interval [CI], 0.68-0.88; P < .001) and OS (HR, 0.82; 95% CI, 0.74-0.92; P < .001). These associations were consistent across subgroups, including sexes, tumor stages, and age cohorts, and in CRC patients who suffered from diabetes and hypertension. CONCLUSION: Statin use is associated with an improved prognosis of curatively resected CRC.
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