Correlations between pre-operative statin-treatment with short- and long-term survival following colorectal cancer surgery: A propensity score-matched national cohort study

Abstract Introduction The many effects of statins have attracted considerable attention in oncological treatment. Several preclinical and epidemiological studies have highlighted their potential anti-tumor properties in patients with colorectal cancer, although results have been conflicting. This study aimed to examine the association between statin exposure before colorectal cancer surgery with long and short-term survival outcomes. Methods This retrospective propensity-score adjusted study was conducted on a Danish cohort of patients who underwent elective curative-intended surgery for stage I-III colorectal cancer in 2008–2020, using four national patient databases. The primary and secondary outcomes were overall-, 90-day- and disease-free survival. Propensity scores were calculated using all available data to match patients with and without statin exposure in a 1:1 ratio. Results Following propensity score matching, 7,120 patients were included in the primary analysis. The median follow-up time was 5 years. A Cox proportional hazards model showed no statistically significant difference in overall survival between patients with or without statin exposure 365 days before surgery (HR: 0.93, 95% CI, 0.85–1.02) and no association with 90-day survival (OR: 0.91, 95% CI, 0.76–1.10). However, a subgroup analysis examining a 90-day exposure before surgery found a statistically significant association with increased overall survival (HR: 0.85, 95% CI, 0.77–0.93). Conclusion Although a subgroup of patients with a pre-operative exposure time of 90 days showed statistically significant better overall survival, we found no statistically significant association between statin exposure one year before colorectal cancer surgery and overall survival.