Hyunsoo Chung1,2, Hyun Ju Kim1,2,3, Hyun Chae Jung1, Sang Kil Lee4, Sang Gyun Kim5. 1. Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Dahangno 101, Jongno-gu, Seoul, 110-744, Republic of Korea. 2. Yonsei University Graduate School of Medicine, Seoul, Korea. 3. Health Promotion Center, Seoul National University Hospital, Seoul, Korea. 4. Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea. sklee@yuhs.ac. 5. Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Dahangno 101, Jongno-gu, Seoul, 110-744, Republic of Korea. harley1333@hanmail.net.
Abstract
BACKGROUND: Statins have shown to reduce the risk of various cancers. However, their effects on metachronous recurrence (MR) after endoscopic resection (ER) for early gastric cancer (EGC) are unknown. We evaluate their effects on MR development after ER for EGC. METHODS: We selected 11,568 patients who received ER for EGC from 2002 to 2011 from the Korean National Health Insurance database and classified into 2 groups: control and statins using propensity score matching. Metachronous recurrence was defined as the second ER or gastrectomy performed 6 months after the first ER. RESULTS: Mean follow-up period was 8.8 ± 3.1 years. Statins showed a significantly lower incidence of MR than the control group (12.5% vs 2.2%, respectively, P < 0.01). After conducting competing risk analyses and time-dependent cox regression analysis considering immortal time bias, statins still showed a lower incidence rate of MR compared to that observed in the control group. For the multivariate analysis, statins remained significant (HR 0.17; 95% CI 0.13-0.24, P < 0.01). In the dose-response analysis, an inverse dose-response relationship was identified between MR and statins (P < 0.01). CONCLUSION: Statins was significantly associated with a reduced risk of MR after ER for EGC with an inverse dose-response relationship.
BACKGROUND:Statins have shown to reduce the risk of various cancers. However, their effects on metachronous recurrence (MR) after endoscopic resection (ER) for early gastric cancer (EGC) are unknown. We evaluate their effects on MR development after ER for EGC. METHODS: We selected 11,568 patients who received ER for EGC from 2002 to 2011 from the Korean National Health Insurance database and classified into 2 groups: control and statins using propensity score matching. Metachronous recurrence was defined as the second ER or gastrectomy performed 6 months after the first ER. RESULTS: Mean follow-up period was 8.8 ± 3.1 years. Statins showed a significantly lower incidence of MR than the control group (12.5% vs 2.2%, respectively, P < 0.01). After conducting competing risk analyses and time-dependent cox regression analysis considering immortal time bias, statins still showed a lower incidence rate of MR compared to that observed in the control group. For the multivariate analysis, statins remained significant (HR 0.17; 95% CI 0.13-0.24, P < 0.01). In the dose-response analysis, an inverse dose-response relationship was identified between MR and statins (P < 0.01). CONCLUSION:Statins was significantly associated with a reduced risk of MR after ER for EGC with an inverse dose-response relationship.
Authors: Dag Holmberg; Joonas H Kauppila; Fredrik Mattsson; Johannes Asplund; Wilhelm Leijonmarck; Shao-Hua Xie; Jesper Lagergren Journal: Gastric Cancer Date: 2022-02-15 Impact factor: 7.701
Authors: Tae Jin Kwon; Tae Jun Kim; Hyuk Lee; Yang Won Min; Byung-Hoon Min; Jun Haeng Lee; Jae J Kim Journal: Cancers (Basel) Date: 2021-03-01 Impact factor: 6.639