Introduction

The pleiotropic effects of statins have attracted considerable attention in oncological treatment. Several preclinical and epidemiological studies have highlighted their potential anti-tumor properties in patients with colorectal cancer, although results have been conflicting. This study aimed to examine the association between statin exposure before colorectal cancer surgery with long and short-term survival outcomes.

Methods

This retrospective propensity score-adjusted study was conducted on a Danish cohort of patients who underwent elective curative-intended surgery for stage I–III colorectal cancer in 2008–2020, using four national patient databases. The primary and secondary outcomes were overall, 90-day, and disease-free survival. Propensity scores were calculated using all available data to match patients with and without statin exposure in a 1:1 ratio.

Results

Following propensity score matching, 7120 patients were included in the primary analysis. The median follow-up time was 5 years. A Cox proportional hazards model showed no statistically significant difference in overall survival between patients with or without statin exposure 365 days before surgery (HR 0.93, 95% CI 0.85–1.02) and no association with 90-day survival (OR 0.91, 95% CI 0.76–1.10). However, a subgroup analysis examining a 90-day exposure before surgery found a statistically significant association with increased overall survival (HR 0.85, 95% CI 0.77–0.93).

Conclusion

Although a subgroup of patients with a preoperative exposure time of 90 days showed statistically significant better overall survival, we found no statistically significant association between statin exposure 1 year before colorectal cancer surgery and overall survival.

中文翻译：

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术前他汀类药物治疗与结直肠癌手术后短期和长期生存之间的相关性：倾向评分匹配的国家队列研究

介绍

他汀类药物的多效作用在肿瘤治疗中引起了广泛关注。几项临床前和流行病学研究强调了它们对结直肠癌患者潜在的抗肿瘤特性，尽管结果相互矛盾。本研究旨在探讨结直肠癌手术前他汀类药物暴露与长期和短期生存结果之间的关系。

方法

这项回顾性倾向评分调整研究是对 2008 年至 2020 年接受 I-III 期结直肠癌择期治愈性手术的丹麦患者队列进行的，使用了四个国家患者数据库。主要和次要结局是总体、90 天和无病生存。使用所有可用数据计算倾向评分，以 1:1 的比例匹配使用和未使用他汀类药物的患者。

结果

经过倾向评分匹配后，7120 名患者被纳入主要分析。中位随访时间为 5 年。 Cox 比例风险模型显示，术前 365 天使用或不使用他汀类药物的患者之间的总生存率没有统计学显着差异（HR 0.93，95% CI 0.85–1.02），并且与 90 天生存率没有关联（OR 0.91，95% CI） 0.76–1.10）。然而，对手术前 90 天暴露进行的亚组分析发现，与总生存期延长存在统计学显着相关性（HR 0.85，95% CI 0.77-0.93）。

结论

尽管术前暴露时间为 90 天的患者亚组显示出统计学上显着更好的总生存率，但我们发现结直肠癌手术前 1 年他汀类药物暴露与总生存率之间没有统计学上显着的关联。