title: Statin and Metformin Use Prolongs Survival in Patients With Resectable Pancreatic Cancer.
abstract: OBJECTIVE
  The aim of this study was to investigate the impact of statin and metformin therapy on disease outcome for patients with pancreatic ductal adenocarcinoma (PDAC).
  
  
  METHODS
  This retrospective study included 171 PDAC patients who underwent surgical resection at the Stanford Cancer Institute between 1998 and 2013. No patients received neoadjuvant therapy. Statin and metformin use was defined as use during initial consult and continuing upon discharge from the hospital after surgery. Dose of each medication was recorded, as was the type of statin taken.
  
  
  RESULTS
  The median follow-up for all patients was 11.23 months (range, 0.2-105.0 months). Among the 171 patients included in our analysis, 18 patients (10.5%) took metformin and 34 patients (19.9%) took statins. Statin use was associated with better overall survival (OS) in patients with PDAC (P = 0.011). Metformin use was also associated with better OS (P = 0.035). The use of statins remained significant on multivariate analysis for OS (P = 0.014; hazards ratio, 0.33; 95% confidence interval, 0.139-0.799), but metformin use did not (P = 0.33; hazards ratio 0.60, 95% confidence interval, 0.211-1.675).
  
  
  CONCLUSIONS
  Statin and metformin use is associated with improved OS in patients with resectable PDAC. These medications should be further investigated for possible long-term use in the general population.
authors.affiliation: From the *Department of Radiation Oncology, Stanford Cancer Institute; and †Department of Surgery, Stanford University Medical Center, Stanford, CA.
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Kozak
authors.forename: Eric M
authors.initials: EM
authors.lastname: Anderson
authors.forename: Rie
authors.initials: R
authors.lastname: von Eyben
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Pai
authors.forename: George A
authors.initials: GA
authors.lastname: Poultsides
authors.forename: Brendan C
authors.initials: BC
authors.lastname: Visser
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Norton
authors.forename: Albert C
authors.initials: AC
authors.lastname: Koong
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002140:California; D021441:Carcinoma, Pancreatic Ductal / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D008297:Male; D008687:Metformin / Q000627:therapeutic use*; D008875:Middle Aged; D015999:Multivariate Analysis; D010180:Pancreatectomy / Q000009:adverse effects / Q000401:mortality; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000401:mortality; D016016:Proportional Hazards Models; D065840:Protective Factors; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008687:Metformin