학술논문

Statin Therapy is Associated with Decreased 90-day Postoperative Mortality After Colon Cancer Surgery
Document Type
Source
Diseases of the Colon & Rectum. 65(4):559-565
Subject
Colon cancer
Mortality
Postoperative
Statins
Surgery
Language
English
ISSN
0012-3706
1530-0358
Abstract
BACKGROUND: There have been conflicting reports regarding a protective effect of statin therapy after colon cancer surgery.OBJECTIVE: This study aimed to evaluate the association between statin therapy and the postoperative mortality following elective colon cancer surgery.DESIGN: This population-based cohort study is a retrospective analysis of prospectively collected data from the Swedish Colorectal Cancer Register.SETTINGS: Patient inclusion was achieved by inclusion through a nationwide register.PATIENTS: All adult patients undergoing elective surgery for colon cancer between the period of January 2007 and September 2016 were included in the study. Patients who had received and collected a prescription for statins pre- and postoperatively were allocated to the statin positive cohort.MAIN OUTCOME MEASURES: The primary and secondary outcomes of interest were 90-day all-cause mortality and 90-day cause-specific mortality.RESULTS: A total of 22,337 patients underwent elective surgery for colon cancer during the study period, of whom 6,494 (29%) were classified as statin users. Statin users displayed a significant survival benefit despite being older, having a higher comorbidity burden, and less fit for surgery. Multivariate analysis illustrated significant reductions in the incidence risk for 90-day all-cause mortality (Incidence Rate Ratio = 0.12, p < 0.001) as well as 90-day cause-specific deaths due to sepsis, multiorgan failure, or of cardiovascular and respiratory origin.LIMITATIONS: The limitations of this study include its observational retrospective design, restricting the ability to perform standardized follow-up of statin therapy. Confounding from other uncontrolled variables cannot be excluded.CONCLUSIONS: Statin users had a significant postoperative benefit regarding short-term mortality following elective colon cancer surgery in the current study, however, further research is needed to ascertain if this relationship is causal. See Video Abstract at http://links.lww.com/DCR/B738.