Abstract
Background
Previous studies on statins’ effect on survival of patients with pancreatic ductal
adenocarcinoma (PDAC) report conflicting results.
Aims
To evaluate the association between statin use and PDAC patients’ survival.
Methods
A systematic review and meta-analysis was performed including case-control, cohort
studies and randomized controlled trials assessing the association between statin
use and survival in PDAC patients. Pooled HRs with 95%CIs were calculated using random
effects model; publication bias was assessed through Begg and Mazumdar test and heterogeneity
by I2 value.
Results
14 studies with 33,137 PDAC patients, 40% under statins, were included. Statins use
was associated to a reduced death risk (HR 0.871; 95%CI: 0.819; 0.927; p = 0.0001)
suggesting a protective effect, homogeneous for different geographic areas. This effect
was significant in surgically resected patients (HR 0.50; 95%CI: 0.32; 0.76; p = 0.001)
but not in those with advanced disease (HR 0.78; 95%CI: 0.59; 1.02; p = 0.07). In
studies providing information on statin type, only rosuvastatin resulted associated
to a reduced risk of death (HR 0.88; 95%CI: 0.81; 0.96; p = 0.004).
Conclusions
Statins use is significantly associated with a reduced risk of death in resected PDAC
patients. This finding has to be considered with caution due to publication bias and
the availability of only few studies for sensitivity analyses.
Keywords
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Article info
Publication history
Published online: February 27, 2020
Accepted:
January 23,
2020
Received:
November 26,
2019
Identification
Copyright
© 2020 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
