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April 20, 2026Open Access

The impact of statins on prognostic outcomes in patients with non-metastatic solid cancers: a systematic review and meta-analysis

Key Points

This research examines the association between statin use and prognostic outcomes in non-metastatic solid cancers.
Conducted a systematic review in accordance with PRISMA guidelines.
Performed meta-analyses on time-to-event outcomes.
Utilized the PICO framework for literature search across three databases.
Assessed risk of bias using the Newcastle-Ottawa Scale and quality of evidence with modified GRADE.
Statin use significantly improved overall survival (OS) (HR = 0.84).
Improved disease-free survival (DFS) (HR = 0.78) and cancer-specific survival (CSS) (HR = 0.86).
Gastrointestinal cancers showed better OS with statin use (HR = 0.79).
Urological (HR = 0.85) and gynecological cancers (HR = 0.84) also benefited significantly.

Abstract

Statins are commonly prescribed low-density lipoprotein-lowering drugs that have been used in patients with cancer due to their pleiotropic effects. In this paper, the association between statin use and prognostic outcomes was examined in patients with non-metastatic solid cancer. In accordance with the PRISMA guidelines, a systematic review of the literature was conducted, and meta-analyses of time-to-event outcomes were performed. The literature search was designed using the Participants, Intervention, Comparator, and Outcome (PICO) framework. The search was completed across three different databases: PubMed, The Cochrane Library, and Web of Science. Studies investigating the impact of statin use versus no statin use on oncological survival measures in patients with non-metastatic solid cancers were eligible for inclusion. The outcomes of interest were overall survival (OS), disease-free survival (DFS), recurrence-free survival (RFS), and cancer-specific survival (CSS). Furthermore, the impact of statin use on the tumor microenvironment was an outcome of interest. The risk of bias was assessed using the Newcastle-Ottawa Scale and the quality of the cumulative evidence was evaluated using the modified GRADE approach. A total of 4,131 articles were title and abstract screened of which 106 articles were included in the systematic review and 90 articles in the meta-analysis. The total number of included patients in the meta-analysis was 472,004 Statin use in patients with non-metastatic solid cancer was significantly associated with improved OS (hazard ratio (HR) = 0.84, 95% confidence interval (CI): 0.80–0.88, I2: 89%), RFS (HR = 0.78, 95% CI: 0.69–0.88, I2: 84%), and CSS (HR = 0.86, 95% CI: 0.81–0.91, I2: 81%). Statin use showed significantly improved OS in patients with gastrointestinal cancer (HR = 0.79, 95% CI: 0.72–0.87, I2: 88%), urological cancer (HR = 0.85, 95% CI: 0.77–0.94, I2: 86%), and gynecological cancer (HR = 0.84, 95% CI: 0.74–0.95, I2: 0%). Conclusions. Statin therapy was associated with improved survival outcomes in patients with non-metastatic solid cancer, especially in gastrointestinal, urological and gynecological cancers.

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