The association of statin use after cancer diagnosis with survival in pancreatic cancer patients: a SEER-medicare analysis.
The association of statin use after cancer diagnosis with survival in pancreatic cancer patients: a SEER-medicare analysis.
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DOI：
10.1371/journal.pone.0121783
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Goodman MT
中科院分区：
文献类型：
--
作者：
Jeon CY;Pandol SJ;Wu B;Cook-Wiens G;Gottlieb RA;Merz CN;Goodman MT
胰腺癌的预后较差，现有的干预措施只能提供有限的益处。他汀类药物具有抗癌特性，可能会提高胰腺癌患者的生存率。我们试图确定癌症诊断后他汀类药物治疗是否与胰腺导管腺癌 (PDAC) 患者的更长生存期相关。我们使用链接的监测、流行病学和最终结果 (SEER) - 医疗保险索赔文件分析了 7813 名患有 PDAC 的老年患者的数据。癌症诊断后他汀类药物使用的类型、强度和持续时间的信息摘自 Medicare D 部分。我们将他汀类药物视为 Cox 回归模型中的时间相关变量，以确定与总体生存率的关系，并根据随访、年龄、性别、种族、社区收入、分期、分级、肿瘤大小、胰腺切除术、化疗、放疗、肥胖、血脂异常、糖尿病、慢性胰腺炎和慢性胰腺炎进行调整。 阻塞性肺疾病（COPD）。总体而言，当考虑所有 PDAC 患者时，癌症诊断后使用他汀类药物与生存率没有显着相关（HR = 0.94，95%CI 0.89，1.01）。然而，对于 I 级或 II 级 PDAC 患者，癌症诊断后使用他汀类药物可使死亡风险降低 21%（风险比 = 0.79，95% 置信区间 (CI) 0.67、0.93），而对于接受过胰腺切除术的患者、患有慢性胰腺炎的患者以及在癌症诊断前未接受过他汀类药物治疗的患者，其程度相似。我们发现癌症诊断后他汀类药物治疗与低级别可切除 PDAC 患者的生存率提高相关。
Pancreatic cancer has poor prognosis and existing interventions provide a modest benefit. Statin has anti-cancer properties that might enhance survival in pancreatic cancer patients. We sought to determine whether statin treatment after cancer diagnosis is associated with longer survival in those with pancreatic ductal adenocarcinoma (PDAC). We analyzed data on 7813 elderly patients with PDAC using the linked Surveillance, Epidemiology, and End Results (SEER) - Medicare claims files. Information on the type, intensity and duration of statin use after cancer diagnosis was extracted from Medicare Part D. We treated statin as a time-dependent variable in a Cox regression model to determine the association with overall survival adjusting for follow-up, age, sex, race, neighborhood income, stage, grade, tumor size, pancreatectomy, chemotherapy, radiation, obesity, dyslipidemia, diabetes, chronic pancreatitis and chronic obstructive pulmonary disease (COPD). Overall, statin use after cancer diagnosis was not significantly associated with survival when all PDAC patients were considered (HR = 0.94, 95%CI 0.89, 1.01). However, statin use after cancer diagnosis was associated with a 21% reduced hazard of death (Hazard ratio = 0.79, 95% confidence interval (CI) 0.67, 0.93) in those with grade I or II PDAC and to a similar extent in those who had undergone a pancreatectomy, in those with chronic pancreatitis and in those who had not been treated with statin prior to cancer diagnosis. We found that statin treatment after cancer diagnosis is associated with enhanced survival in patients with low-grade, resectable PDAC.
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