title: The association of statin use after cancer diagnosis with survival in pancreatic cancer patients: a SEER-medicare analysis.
abstract: BACKGROUND
  Pancreatic cancer has poor prognosis and existing interventions provide a modest benefit. Statin has anti-cancer properties that might enhance survival in pancreatic cancer patients. We sought to determine whether statin treatment after cancer diagnosis is associated with longer survival in those with pancreatic ductal adenocarcinoma (PDAC).
  
  
  METHODS
  We analyzed data on 7813 elderly patients with PDAC using the linked Surveillance, Epidemiology, and End Results (SEER) - Medicare claims files. Information on the type, intensity and duration of statin use after cancer diagnosis was extracted from Medicare Part D. We treated statin as a time-dependent variable in a Cox regression model to determine the association with overall survival adjusting for follow-up, age, sex, race, neighborhood income, stage, grade, tumor size, pancreatectomy, chemotherapy, radiation, obesity, dyslipidemia, diabetes, chronic pancreatitis and chronic obstructive pulmonary disease (COPD).
  
  
  RESULTS
  Overall, statin use after cancer diagnosis was not significantly associated with survival when all PDAC patients were considered (HR = 0.94, 95%CI 0.89, 1.01). However, statin use after cancer diagnosis was associated with a 21% reduced hazard of death (Hazard ratio = 0.79, 95% confidence interval (CI) 0.67, 0.93) in those with grade I or II PDAC and to a similar extent in those who had undergone a pancreatectomy, in those with chronic pancreatitis and in those who had not been treated with statin prior to cancer diagnosis.
  
  
  CONCLUSIONS
  We found that statin treatment after cancer diagnosis is associated with enhanced survival in patients with low-grade, resectable PDAC.
authors.affiliation: Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America; Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, United States of America; Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America.
authors.forename: Christie Y
authors.initials: CY
authors.lastname: Jeon
authors.affiliation: Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America; Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America; Department of Veterans Affairs, Los Angeles, CA, United States of America; Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Pandol
authors.affiliation: Department of Gastroenterology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, United States of America.
authors.forename: Bechien
authors.initials: B
authors.lastname: Wu
authors.affiliation: Biostatistics and Bioinformatics Research Center, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America.
authors.forename: Galen
authors.initials: G
authors.lastname: Cook-Wiens
authors.affiliation: Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America; Barbra Streisand Women's Heart Center, Heart Institute of Cedars-Sinai, Los Angeles, CA, United States of America.
authors.forename: Roberta A
authors.initials: RA
authors.lastname: Gottlieb
authors.forename: C Noel Bairey
authors.initials: CN
authors.lastname: Merz
authors.affiliation: Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America; Barbra Streisand Women's Heart Center, Heart Institute of Cedars-Sinai, Los Angeles, CA, United States of America; Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America.
authors.forename: Noel Bairey
authors.initials: NB
authors.lastname: Merz
authors.affiliation: Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America; Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America; Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America.
authors.forename: Marc T
authors.initials: MT
authors.lastname: Goodman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D021441:Carcinoma, Pancreatic Ductal / Q000188:drug therapy* / Q000401:mortality; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D008297:Male; D006278:Medicare; D015999:Multivariate Analysis; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000401:mortality; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018426:SEER Program; D016896:Treatment Outcome; D014481:United States
chemical_list: D000970:Antineoplastic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
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