Impact of preoperative statin medication on long-term outcomes after pancreatoduodenectomy for ductal adenocarcinoma: an international multicentric cross-sectional study.

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_743656FAC039
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Impact of preoperative statin medication on long-term outcomes after pancreatoduodenectomy for ductal adenocarcinoma: an international multicentric cross-sectional study.
Journal
Journal of cancer research and clinical oncology
Author(s)
Joliat G.R., Gaspar-Figueiredo S., Labgaa I., Vrochides D., Perinel J., Adham M., Demartines N., Schäfer M.
ISSN
1432-1335 (Electronic)
ISSN-L
0171-5216
Publication state
Published
Issued date
12/2023
Peer-reviewed
Oui
Volume
149
Number
19
Pages
17007-17014
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Statin treatment has been shown in certain population studies and meta-analyses to improve survival of patients with pancreatic ductal adenocarcinoma (PDAC). This study assessed if patients with statin treatment had better overall survival (OS) and disease-free survival (DFS) after upfront pancreatoduodenectomy for PDAC.
Consecutive PDAC patients were retrospectively collected from three centers in Europe and USA (study period: 2000-2017). Adult patients who underwent upfront pancreatoduodenectomy and survived the first 90 postoperative days were included. Patients with metastasis at diagnosis or with macroscopic incomplete resection were excluded. Patients were considered under statin if started at least one month before pancreatoduodenectomy. Survival rates were calculated using Kaplan-Meier method and compared with log-rank test.
A total of 496 patients were included. Median age was 67 years (IQR 59-75), 48% (n = 236) were women, and 141 patients (28%) received statin treatment already preoperatively. Patients with and without statin treatment were comparable in terms of demographics and pre-/intraoperative characteristics, except for age and pre-existing diabetes. Median OS and DFS were similar in patients with and without statin treatment (OS: 29, 95% CI 22-36 vs. 27 months, 95% CI 22-32, p = 0.370, DFS: 18, 95% CI 14-22 vs. 16 months, 95% CI 14-18, p = 0.430). On multivariable Cox regression, lymph node involvement (HR 1.9, 95% CI 1.6-2.2, p < 0.001), tumor differentiation (HR 1.3, 95% CI 1.1-1.6, p = 0.003), and postoperative chemotherapy (HR 0.5, 95% CI 0.4-0.7, p < 0.001) were predictors of OS, whereas statin treatment was not a prognostic factor (HR 0.9, 95% CI 0.7-1.2, p = 0.376).
In this international cohort of PDAC patients, statin treatment did not influence survival after upfront pancreatoduodenectomy. Nodal involvement, tumor differentiation, and postoperative chemotherapy were independent predictors of OS.
Keywords
Adult, Humans, Female, Aged, Male, Pancreaticoduodenectomy, Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use, Cross-Sectional Studies, Retrospective Studies, Pancreatic Neoplasms/drug therapy, Pancreatic Neoplasms/surgery, Pancreatic Neoplasms/pathology, Carcinoma, Pancreatic Ductal/drug therapy, Carcinoma, Pancreatic Ductal/surgery, Adenocarcinoma/drug therapy, Adenocarcinoma/surgery, Prognosis, Medication, Outcomes, Pancreas surgery
Pubmed
Web of science
Open Access
Yes
Create date
29/09/2023 15:09
Last modification date
24/11/2023 8:21
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