Dag Holmberg, Joonas H Kauppila, Johannes Asplund, Wilhelm Leijonmarck, Fredrik Mattsson, Jesper Lagergren
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The exposure was statin use during the year prior to gastrectomy which was compared to no such use during the same period. The outcomes were 5-year disease-specific mortality (main) and 5-year all-cause mortality (secondary). Multivariable Cox regression provided hazard ratios (HR) with 95% confidence intervals (CI), adjusted for age, sex, education, calendar year, comorbidity, low-dose aspirin use, tumour sublocation, pathological tumour stage, neoadjuvant chemotherapy, annual surgeon volume, and surgical radicality.</p><p><strong>Results: </strong>Among 1515 participating patients, the mean age was 69 years and 58.4% were men. Statin use, identified in 399 (26.3%) patients, was not associated with any statistically significantly decreased 5-year disease-specific mortality (HR 0.99, 95% CI 0.82-1.21) or 5-year all-cause mortality (HR 0.94, 95% CI 0.79-1.12). 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引用次数: 0
摘要
背景：研究表明，他汀类药物可提高胃癌患者的生存率，但由于方法学问题，其可解释性受到限制，无法得出结论。我们旨在为他汀类药物是否能提高胃腺癌患者的生存率提供有效证据：这项基于人口的全国性队列研究纳入了 2006 年至 2015 年期间在瑞典接受胃腺癌根治性手术（胃切除术）的几乎所有患者，并在 2019 年和 2020 年分别对其疾病特异性死亡率和全因死亡率进行了随访。数据来自医疗记录和国家医疗登记。研究对象是胃切除术前一年使用他汀类药物的患者，并与同期未使用他汀类药物的患者进行比较。研究结果为5年疾病特异性死亡率（主要）和5年全因死亡率（次要）。经调整年龄、性别、教育程度、日历年、合并症、低剂量阿司匹林使用情况、肿瘤亚定位、肿瘤病理分期、新辅助化疗、外科医生年工作量和手术根治率后，多变量考克斯回归得出了危险比（HR）及95%置信区间（CI）：在 1515 名参与研究的患者中，平均年龄为 69 岁，58.4% 为男性。399名（26.3%）患者使用了他汀类药物，但5年疾病特异性死亡率（HR 0.99，95% CI 0.82-1.21）或5年全因死亡率（HR 0.94，95% CI 0.79-1.12）均未出现统计学意义上的显著下降。在不同年龄、性别、阿司匹林使用者状况或肿瘤分期的亚组中，或在术前术后长期使用他汀类药物的患者中，均未发现风险降低的情况，其点估计值均接近1.结论：在瑞典，围手术期使用他汀类药物似乎并不能提高胃腺癌根治性胃切除术患者的5年生存率。
Statin use in relation to long-term survival after gastrectomy for gastric adenocarcinoma: a Swedish population-based cohort study.
Background: Studies have suggested that medication with statins improves survival in patients with gastric cancer, but methodological issues have limited the interpretability and prohibited conclusive results. We aimed to provide valid evidence as to whether statin use improves survival of gastric adenocarcinoma.
Methods: This nationwide and population-based cohort study included virtually all patients who underwent curatively intended surgery (gastrectomy) for gastric adenocarcinoma in Sweden between 2006 and 2015 with follow-up throughout 2019 for disease-specific mortality and 2020 for all-cause mortality. Data came from medical records and national healthcare registries. The exposure was statin use during the year prior to gastrectomy which was compared to no such use during the same period. The outcomes were 5-year disease-specific mortality (main) and 5-year all-cause mortality (secondary). Multivariable Cox regression provided hazard ratios (HR) with 95% confidence intervals (CI), adjusted for age, sex, education, calendar year, comorbidity, low-dose aspirin use, tumour sublocation, pathological tumour stage, neoadjuvant chemotherapy, annual surgeon volume, and surgical radicality.
Results: Among 1515 participating patients, the mean age was 69 years and 58.4% were men. Statin use, identified in 399 (26.3%) patients, was not associated with any statistically significantly decreased 5-year disease-specific mortality (HR 0.99, 95% CI 0.82-1.21) or 5-year all-cause mortality (HR 0.94, 95% CI 0.79-1.12). No risk reductions were found across subgroups of age, sex, aspirin user status, or tumour stage, or in patients with long-term preoperative of postoperative use of statins, all with point estimates close to 1.
Conclusions: Perioperative use of statins does not seem to improve the 5-year survival in patients who undergo gastrectomy with curative intent for gastric adenocarcinoma in Sweden.
期刊介绍：
Gastric Cancer is an esteemed global forum that focuses on various aspects of gastric cancer research, treatment, and biology worldwide.
The journal promotes a diverse range of content, including original articles, case reports, short communications, and technical notes. It also welcomes Letters to the Editor discussing published articles or sharing viewpoints on gastric cancer topics.
Review articles are predominantly sought after by the Editor, ensuring comprehensive coverage of the field.
With a dedicated and knowledgeable editorial team, the journal is committed to providing exceptional support and ensuring high levels of author satisfaction. In fact, over 90% of published authors have expressed their intent to publish again in our esteemed journal.
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