SNFGE SNFGE
 
Thématique :
- Pancréas/Voies biliaires
Originalité :
Réexamen
Solidité :
A confirmer
Doit faire évoluer notre pratique :
Pas encore
 
 
Nom du veilleur :
Professeur Vinciane REBOURS
Coup de coeur :
 
 
Clinical Gastroenterology and Hepatology
  2018/08  
 
  2018 Aug;16(8):1300-1306.e3.  
  doi: 10.1016/j.cgh.2018.02.022.  
 
  Prediagnosis Use of Statins Associates With Increased Survival Times of Patients With Pancreatic Cancer  
 
  Hamada T, Khalaf N, Yuan C, Morales-Oyarvide V, Babic A, Nowak JA, Qian ZR, Ng K, Rubinson DA, Kraft P, Giovannucci EL, Stampfer MJ, Fuchs CS, Ogino S, Wolpin BM  
  https://www.ncbi.nlm.nih.gov/pubmed/29474971  
 
 

Abstract

BACKGROUND & AIMS:

Statin medications, most commonly prescribed to reduce lipid levels and prevent cardiovascular disease, may be associated with longer survival times of patients with cancer. However, the association of statins with outcomes of patients with pancreatic adenocarcinoma is not clear.

METHODS:

We analyzed the association of statin use before a diagnosis of pancreatic cancer with survival times of 648 participants in the Nurses' Health Study and Health Professionals Follow-up Study who were diagnosed with pancreatic adenocarcinoma from 2000 through 2013. We estimated hazard ratios (HRs) for overall mortality using Cox proportional hazards models with adjustment for potential confounders. We assessed the temporal association between prediagnosis statin use and cancer survival by 2-year lag periods to account for a possible latency period between statin use and cancer survival.

RESULTS:

Regular statin use before diagnosis of pancreatic cancer was associated with modestly prolonged survival compared with nonregular use (adjusted HR, 0.82; 95% CI, 0.69-0.97; P = .02). A 1-month longer median survival was observed in regular statin users compared with nonregular users. Regular statin use within the 2 years prior to cancer diagnosis was most strongly associated with longer survival. We observed no statistically significant effect modification by smoking status, body mass index, diabetes, or cancer stage (all Pinteraction > .53). Regular statin use before diagnosis was similarly associated with survival in the Nurses' Health Study (HR, 0.79; 95% CI, 0.64-0.97) and Health Professionals Follow-up Study (HR, 0.86; 95% CI, 0.63-1.15).

CONCLUSIONS:

Regular statin use before diagnosis of pancreatic cancer was associated with modest increases in survival times in 2 large prospective cohort studies.

 

 
Question posée
 
La prise de statines (avant le diagnostic de cancer du pancréas) influe-t-elle sur la survie au cours du cancer du pancréas ?
 
Question posée
 
En moyenne, la survie au cours du cancer du pancréas serait augmentée de 1 mois chez les patients utilisateurs de statines avant le diagnostic de cancer.
 
Commentaires

Inclusion de 648 patients pris en charge pour Adénocarcinome du pancréas. La prise régulière de statines avant le diagnostic de cancer permettrait un gain modeste de survie, en moyenne de 1 mois (adjusted HR, 0.82; 95% CI, 0.69–0.97 ; P=0.02). Cependant cet effet n’est observé que pour les patients ayant consommé des statines dans les 2 ans précédents ce diagnostic et non pour les consommateurs réguliers de statines depuis plus de 2 ans. Il est donc difficile de tirer des conclusions de cette étude.

 
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