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

• Published in: Journal of cancer research and clinical oncology 2023-12, Vol.149 (19), p.17007-17014
• Main Authors: Joliat, Gaëtan-Romain, Gaspar-Figueiredo, Sérgio, Labgaa, Ismail, Vrochides, Dionisios, Perinel, Julie, Adham, Mustapha, Demartines, Nicolas, Schäfer, Markus
• Format: Article
• Language: English
• Subjects: Adenocarcinoma; Adenocarcinoma - drug therapy; Adenocarcinoma - surgery; Adult; Aged; Cancer Research; Carcinoma, Pancreatic Ductal - drug therapy; Carcinoma, Pancreatic Ductal - surgery; Chemotherapy; Cross-Sectional Studies; Diabetes mellitus; Female; Hematology; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Internal Medicine; Lymph nodes; Male; Medicine; Medicine & Public Health; Metastases; Oncology; Pancreatic cancer; Pancreatic Neoplasms; Pancreatic Neoplasms - drug therapy; Pancreatic Neoplasms - pathology; Pancreatic Neoplasms - surgery; Pancreaticoduodenectomy; Population studies; Prognosis; Retrospective Studies; Survival; Tumors
• ISSN: 0171-5216; 1432-1335
• DOI: 10.1007/s00432-023-05426-2

Purpose 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. Methods 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. Results 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