Abstract

Introduction: Pancreatic Ductal Adenocarcinoma (PDAC) remains a major cause of cancer-related mortality. Statins have been shown to exert anti-tumour effects by inducing apoptosis, inhibiting angiogenesis and preventing metastasis. The role of statins in PDAC however, is not yet established. In this study, we have studied the impact of statins on the overall survival in patients diagnosed with PDAC.

Methods: This was a prospective observational cohort study where all consecutive patients with histologic evidence of PDAC between January 2017 to December 2019 were included. Patients were classified as statin users if they had taken statins for minimum of 3 months prior to the diagnosis and continued the medication for a minimum of 30 days after the diagnosis of PDAC. Primary outcome of the study was overall survival. Stratified analysis was performed with respect to stage (metastatic vs non-metastatic) and treatment modality offered (curative resection, palliative chemotherapy, palliative biliary drainage).

Results: A total of 185 patients diagnosed with PDAC were included (mean age 62±12.06, M: F=1.6). Overall, 33/185 patients (17.8%) were found to be on statins. On multivariate analysis, statins were found to have an independent association with overall survival (HR-0.34, 95% CI 0.19- 0.78, p value 0.009). In stratified analysis, statins provided a survival benefit in metastatic disease (p value 0.05) and patients on conservative management (p value 0.04).

Conclusion: Statins were found to reduce the overall risk of mortality by 66% in patients with PDAC. The effect of statins was most evident in patients with advanced metastatic disease.

Keywords: Pancreas; Cancer; Adenocarcinoma; Statins; Survival; Atorvastatin