Statin Use After Colorectal Cancer Diagnosis and Survival: A Population-Based Cohort Study
Statin Use After Colorectal Cancer Diagnosis and Survival: A Population-Based Cohort Study
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DOI：
10.1200/jco.2013.54.4569
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发表时间：
2014-10-01
影响因子：
45.3
通讯作者：
Murray, Liam J.
中科院分区：
文献类型：
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作者：
Cardwell, Chris R.;Hicks, Blanaid M.;Murray, Liam J.
目的探讨在结直肠癌确诊后应用他汀类药物是否降低了结直肠癌患者的结直肠癌特异性死亡风险。这一队列与提供处方记录的英国临床实践研究数据链以及国家统计局的死亡数据(截至2012年)相关联，以确定1647例结直肠癌特有的死亡病例。使用时间依赖的Cox回归模型计算癌症特异性死亡率和诊断后使用他汀类药物的95%CI的风险比(HR)，并针对潜在的混杂因素调整这些HR。结果总的来说，结直肠癌确诊后使用他汀类药物与降低结直肠癌特异性死亡率相关(完全调整后的HR，0.71；95%CI，0.61至0.84)。剂量-反应关系很明显；例如，使用他汀类药物1年以上的结直肠癌患者的降幅更明显(调整后的HR，0.64；95%CI，0.53至0.79)。在结直肠癌确诊后，使用他汀类药物的患者全因死亡率也明显降低(完全调整后的HR，0.75；95%CI，0.66至0.84)。结论在这一大型人群队列中，结直肠癌确诊后使用他汀类药物与较长的存活率相关。(C)美国临床肿瘤学会2014年
PurposeTo investigate whether statins used after colorectal cancer diagnosis reduce the risk of colorectal cancer-specific mortality in a cohort of patients with colorectal cancer.Patients and MethodsA cohort of 7,657 patients with newly diagnosed stage I to III colorectal cancer were identified from 1998 to 2009 from the National Cancer Data Repository (comprising English cancer registry data). This cohort was linked to the United Kingdom Clinical Practice Research Datalink, which provided prescription records, and to mortality data from the Office of National Statistics (up to 2012) to identify 1,647 colorectal cancer-specific deaths. Time-dependent Cox regression models were used to calculate hazard ratios (HR) for cancer-specific mortality and 95% CIs by post-diagnostic statin use and to adjust these HRs for potential confounders.ResultsOverall, statin use after a diagnosis of colorectal cancer was associated with reduced colorectal cancer-specific mortality (fully adjusted HR, 0.71; 95% CI, 0.61 to 0.84). A dose-response association was apparent; for example, a more marked reduction was apparent in colorectal cancer patients using statins for more than 1 year (adjusted HR, 0.64; 95% CI, 0.53 to 0.79). A reduction in all-cause mortality was also apparent in statin users after colorectal cancer diagnosis (fully adjusted HR, 0.75; 95% CI, 0.66 to 0.84).ConclusionIn this large population-based cohort, statin use after diagnosis of colorectal cancer was associated with longer rates of survival. (C) 2014 by American Society of Clinical Oncology