title: Relationship between statin use and colon cancer recurrence and survival: results from CALGB 89803.
abstract: BACKGROUND
  Although preclinical and epidemiological data suggest that statins may have antineoplastic properties, the impact of statin use on patient survival after a curative resection of stage III colon cancer is unknown.
  
  
  METHODS
  We conducted a prospective observational study of 842 patients with stage III colon cancer enrolled in a randomized adjuvant chemotherapy trial from April 1999 to May 2001 to investigate the relationship between statin use and survival. Disease-free survival (DFS), recurrence-free survival (RFS), and overall survival (OS) were investigated by Kaplan-Meier curves and log-rank tests in the overall study population and in a subset of patients stratified by KRAS mutation status (n = 394), and Cox proportional hazards regression was used to assess the simultaneous impact of confounding variables. All statistical tests were two-sided.
  
  
  RESULTS
  Among 842 patients, 134 (15.9%) reported statin use after completing adjuvant chemotherapy. DFS among statin users and nonusers was similar (hazard ratio [HR] of cancer recurrence or death = 1.04, 95% confidence interval [CI] = 0.73 to 1.49). RFS and OS were also similar between statin users and nonusers (adjusted HR of cancer recurrence = 1.14, 95% CI = 0.77 to 1.69; adjusted HR of death = 1.15, 95% CI = 0.77 to 1.71). Survival outcomes were similar regardless of increasing duration of statin use before cancer diagnosis (P(trend) = .63, .63, and .59 for DFS, RFS, and OS, respectively). The impact of statin use did not differ by tumor KRAS mutation status, with similar DFS, RFS, and OS for statin use among mutant and wild-type subgroups (P(interaction) = .84, .67, and .98 for DFS, RFS, and OS, respectively).
  
  
  CONCLUSIONS
  Statin use during and after adjuvant chemotherapy was not associated with improved DFS, RFS, or OS in patients with stage III colon cancer, regardless of KRAS mutation status.
authors.affiliation: Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA 02215, USA. kng4@partners.org
authors.forename: Kimmie
authors.initials: K
authors.lastname: Ng
authors.forename: Shuji
authors.initials: S
authors.lastname: Ogino
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Meyerhardt
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Chan
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Chan
authors.forename: Donna
authors.initials: D
authors.lastname: Niedzwiecki
authors.forename: Donna
authors.initials: D
authors.lastname: Hollis
authors.forename: Leonard B
authors.initials: LB
authors.lastname: Saltz
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Mayer
authors.forename: Al B
authors.initials: AB
authors.lastname: Benson
authors.forename: Paul L
authors.initials: PL
authors.lastname: Schaefer
authors.forename: Renaud
authors.initials: R
authors.lastname: Whittom
authors.forename: Alexander
authors.initials: A
authors.lastname: Hantel
authors.forename: Richard M
authors.initials: RM
authors.lastname: Goldberg
authors.forename: Monica M
authors.initials: MM
authors.lastname: Bertagnolli
authors.forename: Alan P
authors.initials: AP
authors.lastname: Venook
authors.forename: Charles S
authors.initials: CS
authors.lastname: Fuchs
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D003110:Colonic Neoplasms / Q000188:drug therapy / Q000235:genetics / Q000401:mortality* / Q000473:pathology*; D015986:Confounding Factors, Epidemiologic; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009367:Neoplasm Staging; D016017:Odds Ratio; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011518:Proto-Oncogene Proteins / Q000235:genetics*; D016283:Proto-Oncogene Proteins p21(ras); D018570:Risk Assessment; D012307:Risk Factors; D018631:ras Proteins / Q000235:genetics*
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; C117307:KRAS protein, human; D011518:Proto-Oncogene Proteins; D016283:Proto-Oncogene Proteins p21(ras); D018631:ras Proteins