The association of statin use after cancer diagnosis with survival in pancreatic cancer patients: a SEER-medicare analysis

• Published in: PloS one 2015-04, Vol.10 (4), p.e0121783-e0121783
• Main Authors: Jeon, Christie Y, Pandol, Stephen J, Wu, Bechien, Cook-Wiens, Galen, Gottlieb, Roberta A, Merz, C Noel Bairey, Merz, Noel Bairey, Goodman, Marc T
• Format: Article
• Language: English
• Subjects: Adenocarcinoma; Aged; Aged, 80 and over; Anticancer properties; Antineoplastic Agents - therapeutic use; Autophagy; Cancer; Carcinoma, Pancreatic Ductal - drug therapy; Carcinoma, Pancreatic Ductal - mortality; Cardiology; Chemotherapy; Cholesterol; Chronic obstructive pulmonary disease; Confidence intervals; Data processing; Dependent variables; Diabetes mellitus; Diagnosis; Dyslipidemia; Epidemiology; Female; Gastroenterology; Geriatrics; Government programs; Health care; Health services; Heart; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Kaplan-Meier Estimate; Lung diseases; Male; Medical diagnosis; Medical prognosis; Medicare; Medicine; Metastasis; Multivariate Analysis; Obstructive lung disease; Older people; Pancreatic cancer; Pancreatic Neoplasms - drug therapy; Pancreatic Neoplasms - mortality; Pancreatitis; Patients; Physicians; Population; Proportional Hazards Models; Radiation; Regression analysis; Regression models; Retrospective Studies; SEER Program; Statins; Statistical analysis; Studies; Survival; Treatment Outcome; United States
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0121783

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.