Statin use and its effect on all-cause mortality of melanoma patients

A population-based Dutch cohort study

E. Livingstone, L.M. Hollestein, M.P.P. van Herk-Sukel, L. van de Poll-Franse, A. Joosse, B. Schilling, T.E.C. Nijsten, D. Schadendorf, E. de Vries

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Abstract

Preclinical data showed anticancer effects of statins in melanoma, but meta-analyses could not demonstrate a reduced melanoma incidence in statin users. Rather than preventing occurrence, statins might reduce growth and metastatic spread of melanomas and ultimately improve survival. In this population-based study, we investigated the relationship between statin use and survival of melanoma patients. Patients ≥18 years who were diagnosed with cutaneous melanoma (Breslow thickness >1 mm) and registered in the Eindhoven Cancer Registry and in PHARMO Database Network between 1 January 1998 and 31 December 2010 were eligible. The hazard ratio (HR) of all-cause mortality was calculated by employing adjusted time-dependent and time-fixed Cox proportional hazard models. Disease-specific survival was estimated by means of 3-year relative survival rates (RSR). A control cohort of randomly selected patients using statins from PHARMO Database Network matched on age and gender was used to compare RSR of statin users to the general population. After melanoma diagnosis, 171 of 709 patients used statins. Use of statins showed a nonsignificantly decreased hazard of death (adjusted HR 0.76, 95% confidence interval [CI] 0.50–1.61). After stratification for gender, male but not female statin users showed a favorable outcome compared to nonusers (HR 0.57, 95% CI 0.32–0.99; HR 1.22, 95% CI 0.62–2.38, respectively). Three-year RSR for male statin users tended to be higher than for nonusers (91% vs. 80.5%, P = 0.06), no differences were observed in women (87.1% vs. 92.5%, P = 0.76). Statin use was not associated with an improved survival of melanoma patients. The trend for better survival of male in contrast to female statin users warrants further research.
Original languageEnglish
Pages (from-to)1284–1293
JournalCancer Medicine
Volume3
Issue number5
DOIs
Publication statusPublished - 2014

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Melanoma
Survival Rate
Confidence Intervals
Databases
Proportional Hazards Models

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Livingstone, E. ; Hollestein, L.M. ; van Herk-Sukel, M.P.P. ; van de Poll-Franse, L. ; Joosse, A. ; Schilling, B. ; Nijsten, T.E.C. ; Schadendorf, D. ; de Vries, E. / Statin use and its effect on all-cause mortality of melanoma patients : A population-based Dutch cohort study. In: Cancer Medicine. 2014 ; Vol. 3, No. 5. pp. 1284–1293.
@article{7b447ad4e08d4036bf7b8c2ff7bd0c0a,
title = "Statin use and its effect on all-cause mortality of melanoma patients: A population-based Dutch cohort study",
abstract = "Preclinical data showed anticancer effects of statins in melanoma, but meta-analyses could not demonstrate a reduced melanoma incidence in statin users. Rather than preventing occurrence, statins might reduce growth and metastatic spread of melanomas and ultimately improve survival. In this population-based study, we investigated the relationship between statin use and survival of melanoma patients. Patients ≥18 years who were diagnosed with cutaneous melanoma (Breslow thickness >1 mm) and registered in the Eindhoven Cancer Registry and in PHARMO Database Network between 1 January 1998 and 31 December 2010 were eligible. The hazard ratio (HR) of all-cause mortality was calculated by employing adjusted time-dependent and time-fixed Cox proportional hazard models. Disease-specific survival was estimated by means of 3-year relative survival rates (RSR). A control cohort of randomly selected patients using statins from PHARMO Database Network matched on age and gender was used to compare RSR of statin users to the general population. After melanoma diagnosis, 171 of 709 patients used statins. Use of statins showed a nonsignificantly decreased hazard of death (adjusted HR 0.76, 95{\%} confidence interval [CI] 0.50–1.61). After stratification for gender, male but not female statin users showed a favorable outcome compared to nonusers (HR 0.57, 95{\%} CI 0.32–0.99; HR 1.22, 95{\%} CI 0.62–2.38, respectively). Three-year RSR for male statin users tended to be higher than for nonusers (91{\%} vs. 80.5{\%}, P = 0.06), no differences were observed in women (87.1{\%} vs. 92.5{\%}, P = 0.76). Statin use was not associated with an improved survival of melanoma patients. The trend for better survival of male in contrast to female statin users warrants further research.",
author = "E. Livingstone and L.M. Hollestein and {van Herk-Sukel}, M.P.P. and {van de Poll-Franse}, L. and A. Joosse and B. Schilling and T.E.C. Nijsten and D. Schadendorf and {de Vries}, E.",
year = "2014",
doi = "10.1002/cam4.285",
language = "English",
volume = "3",
pages = "1284–1293",
journal = "Cancer Medicine",
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Livingstone, E, Hollestein, LM, van Herk-Sukel, MPP, van de Poll-Franse, L, Joosse, A, Schilling, B, Nijsten, TEC, Schadendorf, D & de Vries, E 2014, 'Statin use and its effect on all-cause mortality of melanoma patients: A population-based Dutch cohort study', Cancer Medicine, vol. 3, no. 5, pp. 1284–1293. https://doi.org/10.1002/cam4.285

Statin use and its effect on all-cause mortality of melanoma patients : A population-based Dutch cohort study. / Livingstone, E.; Hollestein, L.M.; van Herk-Sukel, M.P.P.; van de Poll-Franse, L.; Joosse, A.; Schilling, B.; Nijsten, T.E.C.; Schadendorf, D.; de Vries, E.

In: Cancer Medicine, Vol. 3, No. 5, 2014, p. 1284–1293.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Statin use and its effect on all-cause mortality of melanoma patients

T2 - A population-based Dutch cohort study

AU - Livingstone, E.

AU - Hollestein, L.M.

AU - van Herk-Sukel, M.P.P.

AU - van de Poll-Franse, L.

AU - Joosse, A.

AU - Schilling, B.

AU - Nijsten, T.E.C.

AU - Schadendorf, D.

AU - de Vries, E.

PY - 2014

Y1 - 2014

N2 - Preclinical data showed anticancer effects of statins in melanoma, but meta-analyses could not demonstrate a reduced melanoma incidence in statin users. Rather than preventing occurrence, statins might reduce growth and metastatic spread of melanomas and ultimately improve survival. In this population-based study, we investigated the relationship between statin use and survival of melanoma patients. Patients ≥18 years who were diagnosed with cutaneous melanoma (Breslow thickness >1 mm) and registered in the Eindhoven Cancer Registry and in PHARMO Database Network between 1 January 1998 and 31 December 2010 were eligible. The hazard ratio (HR) of all-cause mortality was calculated by employing adjusted time-dependent and time-fixed Cox proportional hazard models. Disease-specific survival was estimated by means of 3-year relative survival rates (RSR). A control cohort of randomly selected patients using statins from PHARMO Database Network matched on age and gender was used to compare RSR of statin users to the general population. After melanoma diagnosis, 171 of 709 patients used statins. Use of statins showed a nonsignificantly decreased hazard of death (adjusted HR 0.76, 95% confidence interval [CI] 0.50–1.61). After stratification for gender, male but not female statin users showed a favorable outcome compared to nonusers (HR 0.57, 95% CI 0.32–0.99; HR 1.22, 95% CI 0.62–2.38, respectively). Three-year RSR for male statin users tended to be higher than for nonusers (91% vs. 80.5%, P = 0.06), no differences were observed in women (87.1% vs. 92.5%, P = 0.76). Statin use was not associated with an improved survival of melanoma patients. The trend for better survival of male in contrast to female statin users warrants further research.

AB - Preclinical data showed anticancer effects of statins in melanoma, but meta-analyses could not demonstrate a reduced melanoma incidence in statin users. Rather than preventing occurrence, statins might reduce growth and metastatic spread of melanomas and ultimately improve survival. In this population-based study, we investigated the relationship between statin use and survival of melanoma patients. Patients ≥18 years who were diagnosed with cutaneous melanoma (Breslow thickness >1 mm) and registered in the Eindhoven Cancer Registry and in PHARMO Database Network between 1 January 1998 and 31 December 2010 were eligible. The hazard ratio (HR) of all-cause mortality was calculated by employing adjusted time-dependent and time-fixed Cox proportional hazard models. Disease-specific survival was estimated by means of 3-year relative survival rates (RSR). A control cohort of randomly selected patients using statins from PHARMO Database Network matched on age and gender was used to compare RSR of statin users to the general population. After melanoma diagnosis, 171 of 709 patients used statins. Use of statins showed a nonsignificantly decreased hazard of death (adjusted HR 0.76, 95% confidence interval [CI] 0.50–1.61). After stratification for gender, male but not female statin users showed a favorable outcome compared to nonusers (HR 0.57, 95% CI 0.32–0.99; HR 1.22, 95% CI 0.62–2.38, respectively). Three-year RSR for male statin users tended to be higher than for nonusers (91% vs. 80.5%, P = 0.06), no differences were observed in women (87.1% vs. 92.5%, P = 0.76). Statin use was not associated with an improved survival of melanoma patients. The trend for better survival of male in contrast to female statin users warrants further research.

U2 - 10.1002/cam4.285

DO - 10.1002/cam4.285

M3 - Article

VL - 3

SP - 1284

EP - 1293

JO - Cancer Medicine

JF - Cancer Medicine

SN - 2045-7634

IS - 5

ER -