Statin Use After Diagnosis of Colon Cancer and Patient Survival

Voorneveld, Philip W.; Reimers, Marlies S.; Bastiaannet, E.; Jacobs, Rutger J.; Eijk, Ronald van; Zanders, M.M.J.; Herings, Ron M. C.; Herk‐Sukel, Myrthe P. P. van; Kodach, Liudmila L.; Wezel, Tom van; Kuppen, Peter J.K.; Morreau, Hans; Velde, Cornelis J.H. van de; Hardwick, James C.H.; Liefers, G.J.

doi:10.1053/j.gastro.2017.05.011

Cited by 71 publications

(53 citation statements)

References 40 publications

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“…Generally, six studies involving 86 622 patients reported survival outcomes for patients of pre‐diagnostic statin uses, while 11 studies involving 44 322 patients investigated survival outcomes related to post‐diagnostic statin uses . Eight studies were conducted in Europe (United Kingdom, Denmark, Netherland, Germany), four in North America, and two in Asia (China, Korea) . Six studies investigated patients with stages I‐IV, four with stages I‐III, two with stage III, one with stages II‐III, one with stage IV cancer .…”

Section: Resultsmentioning

confidence: 99%

“…Six studies investigated patients with stages I‐IV, four with stages I‐III, two with stage III, one with stages II‐III, one with stage IV cancer . One study only included patients with rectum cancer, four studies only included patients with colon cancer, while the remaining nine studies included patients with both colon cancer and rectum cancer . The methodological quality of all included case‐control and cohort studies was summarized (Table ).…”

Section: Resultsmentioning

confidence: 99%

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Statin uses and mortality in colorectal cancer patients: An updated systematic review and meta‐analysis

Ding

et al. 2019

Cancer Medicine

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Background Colorectal cancer (CRC) remains one of the most common types of cancer and a leading cause of death worldwide. Previous studies indicated that statins may have a potential protective effect on CRC. Methods We conducted this meta‐analysis to systematically assess the overall and cancer‐specific survival benefit of statin uses on CRC patients. Related references were identified through PubMed, the Cochrane Library, Web of Science, EMBASE, and SCOPUS from inception to August 2017. Adjusted hazard ratios (HRs) were adopted to calculate summary hazard ratios (HRs) with 95% confidence intervals (95% CIs), using a random‐effects model. Results Total fourteen studies involving 130 994 patients were included in this meta‐analysis. Six studies reported the association between pre‐diagnosis statin uses and CRC mortality, while 11 studies investigated mortality in patients using statins after CRC diagnosis. For pre‐diagnosis statin uses, the pooled HR of all‐cause mortality (ACM) was 0.85 (95% CI, 0.79‐0.92) and the pooled HR of cancer‐specific mortality (CSM) was 0.82 (95% CI, 0.79‐0.86). In terms of post‐diagnosis statin uses, the pooled HR of ACM was 0.86 (95% CI, 0.76‐0.98), and the pooled HR of CSM was 0.79 (95% CI, 0.70‐0.89). For post‐diagnosis statin uses, there is no difference in ACM when stratified by KRAS gene (KRAS) mutation status. Results of ACM and CSM did not markedly alter in other subgroup analyses. Conclusion Our meta‐analysis demonstrates that both pre‐diagnosis and post‐diagnosis statin uses are associated with reduced ACM and CSM for CRC patients.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Statin uses and mortality in colorectal cancer patients: An updated systematic review and meta‐analysis

Ding

et al. 2019

Cancer Medicine

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“…In an analysis of 999 colon cancer patients, statin use was correlated with a reduced risk of death from any cause or from cancer. The benefit of statin use was greater for patients whose tumors had intact bone morphogenetic protein signaling independent of KRAS mutation status 44 . Simvastatin also affected OCM-1 cell growth, apoptosis and cell cycle.…”

Section: Hmgcrmentioning

confidence: 99%

Role of de novo cholesterol synthesis enzymes in cancer

2020

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Despite extensive research in the cancer field, cancer remains one of the most prevalent diseases. There is an urgent need to identify specific targets that are safe and effective for the treatment of cancer. In recent years, cancer metabolism has come into the spotlight in cancer research. Lipid metabolism, especially cholesterol metabolism, plays a critical role in membrane synthesis as well as lipid signaling in cancer. This review focuses on the contribution of the de novo cholesterol synthesis pathway to tumorigenesis, cancer progression and metastasis. In conclusion, cholesterol metabolism could be an effective target for novel anticancer treatment.

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“…They are the most commonly prescribed drugs in Canada: 48.4% of individuals aged 65+ used statins in 2016 [1]. Statins and their influence on cancer risk and survival has been widely debated in 21st century medical literature, with inconclusive findings [2][3][4][5][6]. A potential association between statin use and bladder cancer outcome gained interest in 2006, when a retrospective cohort study was published in the New England Journal of Medicine in which 84 patients with non-muscle invasive bladder cancer had more aggressive disease and a higher rate of tumor progression when taking statins during bacilli Calmette-Guérin therapy [7].…”

Section: Introductionmentioning

confidence: 99%

Statins are Associated with Reduced Overall and Cancer-Specific Mortality in Patients Undergoing Radical Cystectomy for Bladder Cancer

Wissing

O'Flaherty

Dragomir

et al. 2020

BLC

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BACKGROUND: Existing literature provides contrasting data on statin use and bladder cancer (BC) outcome. OBJECTIVE: We evaluated whether (chronic) statin use was associated with clinical outcomes in patients with BC undergoing radical cystectomy (RC). METHODS: Using provincial health administrative databases, we retrospectively identified BC patients undergoing RC in Quebec province in 2000-2015, and collected data from two years before RC until December 2016 or death. We compared patients who chronically used statins before RC to never statin users. Survival analyses were conducted using Kaplan-Meier curves, log-rank tests, and Cox proportional hazards models. Covariates in multivariable analyses were age, sex, Charlson's comorbidity index, year of RC, distance to hospital, hospital type, hospital's and surgeon's annual RC volume, and neoadjuvant chemotherapy. RESULTS: Our cohort contained 1406 chronic and 1754 never statin users. Five-year overall, BC-specific and recurrencefree survival rates were 40.5% (95% confidence interval (95%CI) 37.8-43.2%), 52.8% (95%CI 49.8-55.7%), and 50.1% (95%CI 47.2-53.0%) for chronic statin users, versus 34.9% (95%CI 32.5-37.2%), 45.5% (95%CI 42.9-48.1%), and 43.4% (95%CI 40.9-45.9%) for never statin users (p ≤ 0.001). In multivariable analyses, hazard ratios (HR) for death, BC-specific deaths and recurrences were 0.83 (95%CI 0.75-0.91), 0.81 (95%CI 0.72-0.91), and 0.83 (95%CI 0.74-0.93) for chronic statin users, respectively. Similar observations were made in patients with diabetes and/or cardiovascular comorbidities (p ≤ 0.001). Clinical outcome was not improved in patients who started statins in the year following surgery compared to never statin users (p > 0.4). CONCLUSIONS: Chronic statin use is associated with improved clinical outcome in BC patients undergoing RC in Quebec.

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Statin Use After Diagnosis of Colon Cancer and Patient Survival

Cited by 71 publications

References 40 publications

Statin uses and mortality in colorectal cancer patients: An updated systematic review and meta‐analysis

Statin uses and mortality in colorectal cancer patients: An updated systematic review and meta‐analysis

Role of de novo cholesterol synthesis enzymes in cancer

Statins are Associated with Reduced Overall and Cancer-Specific Mortality in Patients Undergoing Radical Cystectomy for Bladder Cancer

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