Title: “The Association Between Statin Use and Survival of Esophageal Cancer Patients”
Citation: Deng, H. Y., Lan, X., Zheng, X., Zha, P., Zhou, J., Wang, R. L., Jiang, R., & Qiu, X. M. (2019). The association between statin use and survival of esophageal cancer patients: A systematic review and meta-analysis. Medicine, 98(29), e16480. https://doi.org/10.1097/MD.0000000000016480
Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6709309/
The article begins by explaining that not only is esophageal cancer highly prevalent, it has a very poor prognosis with a poor 5-year survival rate (15-34%). Therefore, an investigation into new potential medications with anti-cancer effects for esophageal cancer is important in order to help improve the survival of esophageal cancer patients. Statins (i.e. HMG-CoA reductase inhibitors) have been shown recently to display anticancer effects such as antiproliferation and proapoptosis, and therefore their impact on risk and prognosis of various cancers have become more widely studied over the past several years. There have been previous studies that showed statins effectively lowered the risk of esophageal cancer especially adenocarcinoma in patients with Barrett’s Esophagus; however the impact of statins on survival of esophageal cancer patients has been unclear, due to conflicting results and biases of previous studies. The goal of this current study was to conduct a systematic review and meta-analysis of previous studies to evaluate the impact of statin use on long-term survival of esophageal cancer patients.
The systematic review and meta-analysis included a total of 4 cohort studies with 20,435 esophageal cancer patients, 5,319 of which were statin users while 15,116 were non-users. The meta-analysis found that statin use after diagnosis of esophageal cancer significantly reduced mortality in esophageal cancer patients regardless of the pathological subtypes (either adenocarcinoma or squamous cell carcinoma). Additionally, statin use before diagnosis of esophageal cancer was also shown to significantly reduce mortality in esophageal cancer patients. Therefore, the study overall proved that statin use could significantly decrease the mortality risk of esophageal cancer patients regardless of the time when statins were taken or the pathological subtypes of esophageal cancer. In esophageal squamous cell carcinoma specifically, statins were shown to play an important role in improving prognosis because in inhibiting HMG-CoA reductase, the drug inhibited the growth and migration of esophageal SCC cells, and also decreased cell viability and proliferation of SCC cells.
A major limitation of the study was that the meta-analysis could only include 4 cohort studies, which are studies with relatively less reliable evidence compared to other study designs, which could therefore decrease the validity of this study’s results. Therefore, the study concludes that randomized controlled trials should be conducted to explore the anticancer effects of statins in esophageal cancer patients, in order to definitely conclude that statins do in fact significantly improve the prognosis of esophageal cancer patients.
