An Israeli Gynecologic Oncology Group study of statin use and endometrial cancer prognosis

Abstract

Objective To assess whether statin use by endometrial cancer patients was associated with a survival advantage. Methods A retrospective chart review study, by the Israeli Gynecologic Oncology Group, of consecutive endometrial cancer patients who underwent surgery in one of 11 medical centers between 2002 and 2014. Clinical and pathological reports, and measures of survival were compared between statin users and nonusers. Kaplan‐Meier and Cox proportional hazard models were used to assess the effect of using statins on survival measures. Results Over a mean follow‐up period of 6.2 years (range, 1–12 years) for 2017 endometrial cancer patients with complete data, 663 (32.8%) used statins prior to diagnosis and 1354 (67.1%) did not. No statistically significant differences between the groups were observed for most demographic and clinical characteristics. There was no difference between statin users and nonusers in 5‐year recurrence‐free survival (82% vs 83%; P=0.508), disease‐specific survival (86% vs 84%; P=0.549), or overall survival (77% vs 75%; P=0.901). Conclusions In this large cohort of patients with endometrial cancer, no significant associations were found between use of statins and endometrial cancer survival.

No Association Between Statin Use and the Prognosis of Endometrial Cancer in Women With Type 2 Diabetes

“…Similarly to our study, some previous studies did not observe any association between statin use and better prognosis in endometrial cancer when all histologies were analyzed together ( Yoon et al, 2015 ; Sanni et al, 2017 ; Segev et al, 2020 ). However, some other studies have reported lower mortality from endometrial cancer in type II or non-endometrioid histology ( Nevadunsky et al, 2015 ; Feng et al, 2016 ; Arima et al, 2018 ), while Sperling et al (2018) observed decreased mortality from endometrial cancer and other causes in statin users in both endometrioid and non-endometrioid histologies.…”

“…The only previous study which focused solely on women with T2D was our study in which statin use was associated with lower mortality from non-endometrioid endometrial cancer in a nationwide database consisted of patients with T2D ( Arima et al, 2018 ). The proportion of women with T2D in previous studies explored statin use have varied from 13 to 38% ( Nevadunsky et al, 2015 ; Yoon et al, 2015 ; Feng et al, 2016 ; Sperling et al, 2018 ; Segev et al, 2020 ). The number of women with T2D has not been reported in all studies ( Lavie et al, 2013 ; Sanni et al, 2017 ).…”

Statins: HMG-CoA Reductase Inhibitors as Potential Anticancer Agents against Malignant Neoplasms in Women

“…Surprisingly, the 5-year relapse-free survival did not differ between the group of women with EC who had used statins before diagnosis (633 women, 32.8% of all respondents) and those who had not used them at all (1354 women, 67.1%). The 5-year relapse-free survival was 82% and 83% (p = 0.508), respectively, and the overall survival was 77% and 75% (p = 0.901), respectively [68]. The presented results regarding the impact of statin treatment on the incidence of EC and the course of this cancer seems thus far rather inconclusive.…”

Endometrial cancer—is our knowledge changing?

“…With very limited knowledge of this hypothetical mechanism, more studies are clearly needed. Some studies have found some improvements in patient mortality using statins (87), offering unconventional thought, but additional studies performed in different countries found no association (88). Considering the steady increase in statin use and at the same time increasing incidence of EC, the possible positive correlation between statin use and improved mortality is highly improbable.…”