Statin use improves the prognosis of ovarian cancer: An updated and comprehensive meta-analysis

Qingxue Wang; Zheng Zhi; Hua Han; Qingtao Zhao; Xing Wang; Shumin Cao; Jing Zhao

doi:10.3892/ol.2022.13648

Statin use improves the prognosis of ovarian cancer: An updated and comprehensive meta-analysis

Oncol Lett. 2022 Dec 23;25(2):65. doi: 10.3892/ol.2022.13648. eCollection 2023 Feb.

Authors

Qingxue Wang^{1

2}, Zheng Zhi³, Hua Han⁴, Qingtao Zhao⁵, Xing Wang⁶, Shumin Cao⁷, Jing Zhao²

Affiliations

¹ Graduate School, Hebei North University, Zhangjiakou, Hebei 075000, P.R. China.
² Department of Oncology, Hebei General Hospital, Shijiazhuang, Hebei 050051, P.R. China.
³ Department of Basic Medicine, Hebei University of Chinese Medicine, Shijiazhuang, Hebei 050200, P.R. China.
⁴ Department of Gynecology, Hebei General Hospital, Shijiazhuang, Hebei 050051, P.R. China.
⁵ Department of Thoracic Surgery, Hebei General Hospital, Shijiazhuang, Hebei 050051, P.R. China.
⁶ Department of Clinical Medical Research Center and Geriatric Key Laboratory, Hebei General Hospital, Shijiazhuang, Hebei 050051, P.R. China.
⁷ Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei 050017, P.R. China.

Abstract

Statins are lipid-lowering agents that have also been found to have anticancer effects. The relationship between statin use and clinical outcomes in ovarian cancer (OC) remains controversial, as previous assessments of the relationship between statin use and OC prognosis have yielded inconsistent results. Therefore, a comprehensive meta-analysis was performed in the present study to investigate this association. Studies were systematically retrieved by searching the PubMed, Embase and Cochrane Library databases, and consulting reference lists of the related studies. The search timeframe was from database creation to September 1, 2022. Pooled hazard ratios (HRs) with corresponding 95% confidence intervals (CIs) were calculated to assess the association. In the present meta-analysis, 16 studies with 37,660 patients with OC were included, of which 11,296 patients had been prescribed statins. The results showed that statin use markedly improved the overall survival time (OS; HR, 0.79; 95% CI, 0.73-0.85; P<0.00001) and OC-specific survival time (HR, 0.84; 95% CI, 0.80-0.89; P<0.00001), especially the OS time in patients with serous OC (HR, 0.81; 95% CI, 0.74-0.89; P<0.0001) and endometrioid OC (HR, 0.80; 95% CI, 0.66-0.98; P=0.03). In addition, survival rate was higher in patients who used statins after OC diagnosis (HR, 0.79; 95% CI, 0.73-0.85; P<0.00001). However, there was no statistically significant association between statin use and the prognosis of mucinous and clear cell OC. The results suggested that statin use markedly improved the OS in patients with OC, including in those with serous and endometrioid OC. Statins were also found to improve the prognosis of patients of both Asian and non-Asian ethnicities. In addition, both lipophilic and hydrophilic statins improved the survival in patients with OC, especially in patients using statins after OC diagnosis. However, the effect may vary depending on the statin type, duration of use and cancer type, and more well-designed studies are needed to further evaluate this.

Keywords: lipid-lowering agents; ovarian cancer; overall survival; prognosis; statin.

Grants and funding

This study was supported by The Key Project Plan of Hebei Province Medical Science Research in 2018 (grant no. 20180013), and the 2020 Hebei Provincial Science and Technology Plan Project (grant no. 20377749D).