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Impact of preoperative statin medication on long-term outcomes after pancreatoduodenectomy for ductal adenocarcinoma: an international multicentric cross-sectional study
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...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10657279/ https://www.ncbi.nlm.nih.gov/pubmed/37740766 http://dx.doi.org/10.1007/s00432-023-05426-2 |
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author | Joliat, Gaëtan-Romain Gaspar-Figueiredo, Sérgio Labgaa, Ismail Vrochides, Dionisios Perinel, Julie Adham, Mustapha Demartines, Nicolas Schäfer, Markus |
author_facet | Joliat, Gaëtan-Romain Gaspar-Figueiredo, Sérgio Labgaa, Ismail Vrochides, Dionisios Perinel, Julie Adham, Mustapha Demartines, Nicolas Schäfer, Markus |
author_sort | Joliat, Gaëtan-Romain |
collection | PubMed |
description | 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 < 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). CONCLUSION: 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. |
format | Online Article Text |
id | pubmed-10657279 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-106572792023-09-23 Impact of preoperative statin medication on long-term outcomes after pancreatoduodenectomy for ductal adenocarcinoma: an international multicentric cross-sectional study Joliat, Gaëtan-Romain Gaspar-Figueiredo, Sérgio Labgaa, Ismail Vrochides, Dionisios Perinel, Julie Adham, Mustapha Demartines, Nicolas Schäfer, Markus J Cancer Res Clin Oncol Research 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 < 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). CONCLUSION: 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. Springer Berlin Heidelberg 2023-09-23 2023 /pmc/articles/PMC10657279/ /pubmed/37740766 http://dx.doi.org/10.1007/s00432-023-05426-2 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Research Joliat, Gaëtan-Romain Gaspar-Figueiredo, Sérgio Labgaa, Ismail Vrochides, Dionisios Perinel, Julie Adham, Mustapha Demartines, Nicolas Schäfer, Markus Impact of preoperative statin medication on long-term outcomes after pancreatoduodenectomy for ductal adenocarcinoma: an international multicentric cross-sectional study |
title | Impact of preoperative statin medication on long-term outcomes after pancreatoduodenectomy for ductal adenocarcinoma: an international multicentric cross-sectional study |
title_full | Impact of preoperative statin medication on long-term outcomes after pancreatoduodenectomy for ductal adenocarcinoma: an international multicentric cross-sectional study |
title_fullStr | Impact of preoperative statin medication on long-term outcomes after pancreatoduodenectomy for ductal adenocarcinoma: an international multicentric cross-sectional study |
title_full_unstemmed | Impact of preoperative statin medication on long-term outcomes after pancreatoduodenectomy for ductal adenocarcinoma: an international multicentric cross-sectional study |
title_short | Impact of preoperative statin medication on long-term outcomes after pancreatoduodenectomy for ductal adenocarcinoma: an international multicentric cross-sectional study |
title_sort | impact of preoperative statin medication on long-term outcomes after pancreatoduodenectomy for ductal adenocarcinoma: an international multicentric cross-sectional study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10657279/ https://www.ncbi.nlm.nih.gov/pubmed/37740766 http://dx.doi.org/10.1007/s00432-023-05426-2 |
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