title: Effects of Statin, Aspirin or Metformin Use on Recurrence-Free and Overall Survival in Patients with Biliary Tract Cancer.
abstract: OBJECTIVE
  The impact of statins, aspirin and metformin use on recurrence-free (RFS) and overall survival (OS) of patients with biliary tract cancer (BTC) has not been evaluated.
  
  
  METHODS
  Baseline demographics/comorbidity and use of statins, aspirin or metformin at diagnosis were evaluated in patients with BTC from January/1987-July/2013.
  
  
  RESULTS
  Median age at diagnosis; 65.7 years, performance status < 2; 795 patients, male; 461 (50.5%). Among 913 patients; 151 (16.5%) reported statin use at diagnosis, 146 (16%) aspirin use, and 81 (9%) metformin use. Charlson Comorbidity index score was not significantly associated with RFS or OS. Stage was prognostic on multivariable analysis for RFS and OS (both P ≤ 0.001) and age, performance status ≥ 2 and site were also prognostic for OS (P < 0.05, P < 0.001, and P < 0.05 respectively). Recurrence-free and OS among statin-users and nonusers was similar (RFS Hazard Ratio [HR]1.11, 95% confidence interval [CI] 0.78 - 1.58, P = 0.57), (OS HR0.98, 95% CI 0.77-1.24, P = 0.86), and among aspirin-users and nonusers (RFS HR0.83, 95% CI 0.57-1.23, P = 0.35), (OS HR1.07, 95% CI 0.85 - 1.34, P = 0.58), and among metformin-users and non-users (RFS HR0.75, 95% CI 0.43-1.30, P = 0.30), (OS HR0.96, 95% CI 0.69-1.33, P = 0.79).
  
  
  CONCLUSIONS
  In this large retrospective cohort of BTC patients, comorbidity, statin, aspirin or metformin use did not have significant effects on RFS or OS.
authors.forename: Mairéad G
authors.initials: MG
authors.lastname: McNamara
authors.forename: Priya
authors.initials: P
authors.lastname: Aneja
authors.forename: Lisa W
authors.initials: LW
authors.lastname: Le
authors.forename: Anne M
authors.initials: AM
authors.lastname: Horgan
authors.forename: Elizabeth
authors.initials: E
authors.lastname: McKeever
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Knox
mesh_terms: D000368:Aged; D001241:Aspirin / Q000627:therapeutic use*; D001661:Biliary Tract Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D015897:Comorbidity; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D008297:Male; D008687:Metformin / Q000627:therapeutic use*; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007004:Hypoglycemic Agents; D008687:Metformin; D001241:Aspirin