Retrospective cohort study of statin therapy effect on resected colorectal liver metastases

• 作者: Adina Olaru Dhanny Gomez Edward Alabraba Hussain Ibrahim Iain Cameron Nottingham HPB Surgery Group
• 来源期刊: 世界胃肠外科杂志:英文版(电子版)
• 学科: 医学
• 关键词: Colorectal LIVER METASTASES STATIN LIVER RESECTION CHEMOPREVENTION TUMOUR biology Survival
• 年，卷（期）: 2020,（2）
• 页码范围: 34-44
• 页数: 11页
• 分类号: R73

摘要

BACKGROUND Above and beyond their role in cardiovascular risk reduction,statins appear to have a chemopreventive role in some gastro-intestinal cancers.In the quest for new chemopreventive agents,some existing established drugs such as statins have shown potential for re-purposing as chemoprevention.Probing existing drugs,whose pharmacodynamics are familiar,for novel beneficial effects offers a more cost-effective and less time-consuming strategy than establishing brand new drugs whose pharmacodynamic profile is unfamiliar.Observational studies show statins decrease the risk of developing colorectal cancer but there are no published studies exploring the potential impact of statins on carcinogenesis in colorectal liver metastases(CRLM).AIM To evaluate impact of statins on outcomes of CRLM resection,and secondarily to assess if statins influence CRLM histo-pathology.METHODS We conducted a retrospective cohort study of patients operated for CRLM over a 13-year period from 2005 to 2017.Patients were identified from a prospective database maintained in our Tertiary care hospital.All 586 patients included the study had undergone resection of CRLM following discussion at multidisclipinary team meeting,some patients requiring neoadjuvant chemotherapy to downstage CRLM prior to surgery.We analysed patient demographics,operative details,CRLM histopathology,Index of Deprivation,neutrophil-to-lymphocyte ratio,platelet-to-lymphocyte ratio and chemotherapy use in relation to clinical outcome.Statistics were performed using SPSS version 16.0;significance taken at 5%.RESULTS Liver resection for CRLM was undertaken in 586 patients at a median age of 68(range 19 to 88)years.Statin therapy was used by 181 patients.Median follow-up time was 23(range 12-96)mo and further colorectal cancer metastases developed in 267 patients.A total of 131 patients died.Multi-variate analysis identified 6 independent predictors of poorer disease-free survival:Synchronous presentation,multiple tumours,tumour size≥5 cm,moderate-severe steatosis,peri