Statin as a Combined Therapy for Advanced-Stage Ovarian Cancer: A Propensity Score Matched Analysis

Abstract

Background. Despite the great achievements in the treatment of advanced-stage ovarian cancer, it is still a severe condition with an unfavorable 5-year survival rate. Statins have been suggested to reduce the risk of several cancers beyond their cholesterol-lowing effects. However, the prognostic significance of statins in patients with advanced-stage ovarian cancer remains controversial. Methods. A retrospective study was performed to evaluate the association between statin intake and overall survival (OS) among patients with advanced-stage ovarian cancer. Patients who underwent cytoreductive surgery followed by courses of intravenous chemotherapy were matched through a propensity score analysis. Results. A total of 60 propensity-matched patients were included. Women in statin group showed a similar OS than the nonstatin counterparts (P = 0.966), whereas residual tumor was significantly associated with better OS (P = 0.013) and was an independent factor that associated with OS (P = 0.002, hazard ratio = 5.460, and 95% confidence interval: 1.894 to 15.742) in multivariable analysis. Conclusions. Our results suggested that statin usage was not associated with improved OS in patients with advanced-stage ovarian cancer undergoing surgery and chemotherapy. Considering the retrospective nature and the relative small sample size of the study, further prospective studies and random control trials are needed.

Impact of postdiagnostic statin use on ovarian cancer mortality: A systematic review and meta‐analysis of observational studies

“…Four of these 12 articles were subsequently excluded for various reasons and a review of the reference lists led to the inclusion of one additional article. Therefore, eight studies were included in the present meta‐analysis.…”

“…Three of the included studies were conducted in Asia , three in Europe and two in America . Most of the cohort studies were retrospective , while two were prospective . The median duration of follow‐up varied across studies from 28.8 to 54 months and the rate of statin use ranged from 11% to 42.6%.…”

“…Seven studies involving 11 745 subjects with OC were used to estimate the summary effects of postdiagnostic statin use on ACM. The summarized HR was 0.74 (95%CI = 0.63–0.87), with moderate heterogeneity ( I 2 = 55%, P = 0.038) (Figure ).…”

“…For one study [21] that did not use the category of never use as a reference to statin use, the effective-count method proposed by Hamling et al [32] was used to recalculate the HRs and 95% CIs. Overall summary estimates were calculated using inverse variance-weighted random effects metaanalysis.…”

“… examined the effect of statin use on the mortality of all cancers, but only included three studies that investigated the correlation between postdiagnostic statin use and mortality of OC patients. However, in view of this meta‐analysis, several relevant high‐quality studies with large sample sizes have been published , with some suggesting that postdiagnostic statin use was associated with decreased mortality of OC , while others failed to find any evidence of such an association. Since reviewing the available evidence may provide insight for further research to understand the potential role of statin use in OC therapy, the aim of the present systematic review and meta‐analysis of observational studies was to assess the effect of postdiagnostic statin use on the mortality/survival of OC patients.…”