Association Between Statin Use and Endometrial Cancer Survival

Nicole S. Nevadunsky, Anne R. Van Arsdale, Howard Strickler, Lori A. Spoozak, Alyson B. Moadel-Robblee, Gurpreet Kaur, Eugenia Girda, Gary L. Goldberg, Mark H. Einstein

Research output: Contribution to journalArticle

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Abstract

Objective: To evaluate the association of 3 hydroxy-3-methyl-glutaryl-coenzyme A reductase inhibitor (statin) use and concordant polypharmacy with disease-specific survival from endometrial cancer. Methods: A retrospective cohort study was conducted of 985 endometrial cancer cases treated from January 1999 through December 2009 at a single institution. Disease-specific survival was estimated by Kaplan-Meier analyses. A Cox proportional hazards model was used to study factors associated with survival. All statistical tests were two-sided and performed using Stata. Results: At the time of analysis, 230 patients (22% of evaluable patients) died of disease and median follow-up was 3.28 years. Disease-specific survival was greater (179/220 [81%]) for women with endometrial cancer taking statin therapy at the time of diagnosis and staging compared with women not using statins (423/570 [74%]) (log rank test, P.03). This association persisted for the subgroup of patients with nonendometrioid endometrial tumors who were statin users (59/87 [68%]) compared with nonusers (93/193 [43%]) (log rank test, P.02). The relationship remained significant (hazard ratio 0.63, 95% confidence interval [CI] 0.40-0.99) after adjusting for age, clinical stage, radiation, and other factors. Further evaluation of polypharmacy showed an association between concurrent statin and aspirin use with an especially low disease-specific mortality (hazard ratio 0.25, 95% CI 0.09-0.70) relative to those who used neither. Conclusion: Statin and aspirin use was associated with improved survival from nonendometrioid endometrial cancer.

Original languageEnglish (US)
Pages (from-to)144-150
Number of pages7
JournalObstetrics and Gynecology
Volume126
Issue number1
DOIs
StatePublished - Jul 23 2015

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Endometrial Neoplasms
Survival
Polypharmacy
Aspirin
Confidence Intervals
Kaplan-Meier Estimate
Proportional Hazards Models
Oxidoreductases
Cohort Studies
Retrospective Studies
Radiation
Mortality
Neoplasms

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Association Between Statin Use and Endometrial Cancer Survival. / Nevadunsky, Nicole S.; Van Arsdale, Anne R.; Strickler, Howard; Spoozak, Lori A.; Moadel-Robblee, Alyson B.; Kaur, Gurpreet; Girda, Eugenia; Goldberg, Gary L.; Einstein, Mark H.

In: Obstetrics and Gynecology, Vol. 126, No. 1, 23.07.2015, p. 144-150.

Research output: Contribution to journalArticle

Nevadunsky, Nicole S. ; Van Arsdale, Anne R. ; Strickler, Howard ; Spoozak, Lori A. ; Moadel-Robblee, Alyson B. ; Kaur, Gurpreet ; Girda, Eugenia ; Goldberg, Gary L. ; Einstein, Mark H. / Association Between Statin Use and Endometrial Cancer Survival. In: Obstetrics and Gynecology. 2015 ; Vol. 126, No. 1. pp. 144-150.
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AU - Strickler, Howard

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AU - Moadel-Robblee, Alyson B.

AU - Kaur, Gurpreet

AU - Girda, Eugenia

AU - Goldberg, Gary L.

AU - Einstein, Mark H.

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N2 - Objective: To evaluate the association of 3 hydroxy-3-methyl-glutaryl-coenzyme A reductase inhibitor (statin) use and concordant polypharmacy with disease-specific survival from endometrial cancer. Methods: A retrospective cohort study was conducted of 985 endometrial cancer cases treated from January 1999 through December 2009 at a single institution. Disease-specific survival was estimated by Kaplan-Meier analyses. A Cox proportional hazards model was used to study factors associated with survival. All statistical tests were two-sided and performed using Stata. Results: At the time of analysis, 230 patients (22% of evaluable patients) died of disease and median follow-up was 3.28 years. Disease-specific survival was greater (179/220 [81%]) for women with endometrial cancer taking statin therapy at the time of diagnosis and staging compared with women not using statins (423/570 [74%]) (log rank test, P.03). This association persisted for the subgroup of patients with nonendometrioid endometrial tumors who were statin users (59/87 [68%]) compared with nonusers (93/193 [43%]) (log rank test, P.02). The relationship remained significant (hazard ratio 0.63, 95% confidence interval [CI] 0.40-0.99) after adjusting for age, clinical stage, radiation, and other factors. Further evaluation of polypharmacy showed an association between concurrent statin and aspirin use with an especially low disease-specific mortality (hazard ratio 0.25, 95% CI 0.09-0.70) relative to those who used neither. Conclusion: Statin and aspirin use was associated with improved survival from nonendometrioid endometrial cancer.

AB - Objective: To evaluate the association of 3 hydroxy-3-methyl-glutaryl-coenzyme A reductase inhibitor (statin) use and concordant polypharmacy with disease-specific survival from endometrial cancer. Methods: A retrospective cohort study was conducted of 985 endometrial cancer cases treated from January 1999 through December 2009 at a single institution. Disease-specific survival was estimated by Kaplan-Meier analyses. A Cox proportional hazards model was used to study factors associated with survival. All statistical tests were two-sided and performed using Stata. Results: At the time of analysis, 230 patients (22% of evaluable patients) died of disease and median follow-up was 3.28 years. Disease-specific survival was greater (179/220 [81%]) for women with endometrial cancer taking statin therapy at the time of diagnosis and staging compared with women not using statins (423/570 [74%]) (log rank test, P.03). This association persisted for the subgroup of patients with nonendometrioid endometrial tumors who were statin users (59/87 [68%]) compared with nonusers (93/193 [43%]) (log rank test, P.02). The relationship remained significant (hazard ratio 0.63, 95% confidence interval [CI] 0.40-0.99) after adjusting for age, clinical stage, radiation, and other factors. Further evaluation of polypharmacy showed an association between concurrent statin and aspirin use with an especially low disease-specific mortality (hazard ratio 0.25, 95% CI 0.09-0.70) relative to those who used neither. Conclusion: Statin and aspirin use was associated with improved survival from nonendometrioid endometrial cancer.

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