Statin use and survival in elderly patients with endometrial cancer.

ABSTRACT

BACKGROUND: Endometrial cancer is the most common gynecologic cancer in the United States. Statins have demonstrated anti-cancer effects in other tumor types, such as the breast and lung cancers. AIM: The objective of our study was to determine the association between statin use and endometrial cancer survival in a nationally-representative elderly population with endometrial cancer in the U.S. METHODS: We employed the linked Surveillance, Epidemiology and End Results registries and Medicare claims files to collect data from 2987 patients who were diagnosed with endometrial cancer between 2007 and 2009 and who received a hysterectomy. The association between statin use and overall survival was examined using Cox regression models adjusting for follow-up time, age, race, neighborhood income, cancer stage, tumor grade, hysterectomy type, chemotherapy, radiation, impaired glucose tolerance, obesity, dyslipidemia and diabetes. RESULTS: The mortality rate was lower in statin users compared to non-users for both type I (4.6 vs. 5.7 deaths/100 person-years, p=0.08) and type II (11.2 vs. 16.5 deaths/100 person-years, p=0.01) cancer types. However, after adjustment for the time from surgery to statin use and confounding, statin use after a hysterectomy was not significantly associated with a reduction in hazard of death for both type I (hazard ratio [HR] 0.92, 95%CI 0.70,1.2) and type II (HR=0.92, 95%CI 0.65, 1.29, p=0.62) endometrial cancer patients. CONCLUSION: Accounting for all confounders and biases considered, statin use on or after a hysterectomy was not associated with survival in those with type I or type II disease.