Abstract
BackgroundStudies have indicated that statins influence the risks and mortality rates of several types of solid tumors. However, the association between statin use and survival in patients with colorectal cancer (CRC) remains unclear.MethodsWe searched the PubMed and Embase databases for relevant studies published up to September 2014 that assessed statin use and CRC prognosis. The primary outcomes were overall survival (OS) and cancer-specific survival (CSS). The secondary outcomes were disease-free survival (DFS) and recurrence-free survival (RFS). Hazard ratios (HRs) and 95% confidence intervals (CIs) were extracted and pooled with Mantel–Haenszel random-effect modeling. All statistical tests were two-sided.ResultsFour studies on post-diagnosis statin therapy and five studies on pre-diagnosis statin use were included in our meta-analysis of 70,608 patients. Compared with the non-users, the patients with post-diagnosis statin use gained survival benefits for OS (HR 0.76; 95% CI: 0.68 to 0.85, P<0.001) and CSS (HR 0.70; 95% CI: 0.60 to 0.81, P<0.001). In addition, we observed that pre-diagnosis statin use prolonged the survival of patients with CRC for OS (HR 0.70; 95% CI: 0.54 to 0.91, P=0.007) and CSS (HR 0.80; 95% CI: 0.74 to 0.86, P<0.001). However, we did not observe a survival benefit for DFS (HR 1.13; 95% CI: 0.78 to 1.62, P=0.514) or RFS (HR 0.98; 95% CI: 0.36 to 2.70, P=0.975) in the CRC patients with post-diagnosis statin use.ConclusionsStatin use before or after cancer diagnosis is related to reductions in overall and cancer-specific mortality in colorectal cancer survivors.
Highlights
As the most widely prescribed drugs for the treatment of hypercholesterolemia, statins or 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase inhibitors have been shown to reduce cardiovascular events and mortality in several randomized clinical trials [1,2,3]
Compared with the non-users, the patients with post-diagnosis statin use gained survival benefits for overall survival (OS) (HR 0.76; 95% confidence intervals (CIs): 0.68 to 0.85, P
We observed that pre-diagnosis statin use prolonged the survival of patients with colorectal cancer (CRC) for OS (HR 0.70; 95% CI: 0.54 to 0.91, P=0.007) and CSS (HR 0.80; 95% CI: 0.74 to 0.86, P
Summary
As the most widely prescribed drugs for the treatment of hypercholesterolemia, statins or 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase inhibitors have been shown to reduce cardiovascular events and mortality in several randomized clinical trials [1,2,3]. They can prevent the progression of malignant cells[4] and modify their adhesive properties [5]. Several studies have reported the effects of statins on the survival outcomes of solid cancers [12]. The association between statin use and survival in patients with colorectal cancer (CRC) remains unclear
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