Statin use and head and neck squamous cell carcinoma outcomes
Getz, Kayla R.; Bellile, Emily; Zarins, Katie R.; Rullman, Cailey; Chinn, Steven B.; Taylor, Jeremy M. G.; Rozek, Laura S.; Wolf, Gregory T.; Mondul, Alison M.
2021-05-15
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Citation
Getz, Kayla R.; Bellile, Emily; Zarins, Katie R.; Rullman, Cailey; Chinn, Steven B.; Taylor, Jeremy M. G.; Rozek, Laura S.; Wolf, Gregory T.; Mondul, Alison M. (2021). "Statin use and head and neck squamous cell carcinoma outcomes." International Journal of Cancer 148(10): 2440-2448.
Abstract
Head and neck squamous cell carcinoma (HNSCC) is a morbid cancer with poor outcomes. Statins possess anticancer properties such as immunomodulatory and anti‐inflammatory effects. The objective of our study is to identify the association between statin use among untreated HNSCC patients and overall death, disease‐specific death and recurrence. HNSCC patients were recruited to participate in the University of Michigan Head and Neck Cancer Specialized Program of Research Excellence (SPORE) from 2003 to 2014. Statin use data were collected through medical record review. Participants were considered a statin user if they used a statin at or after diagnosis. Outcome data were collected through medical record review, Social Security Death Index or LexisNexis. Our analytic cohort included 1638 participants. Cox proportional hazard models were used to estimate the association between ever statin use and HNSCC outcomes. Statin use was seen in 36.0% of participants. We observed a statistically significant inverse association between ever using a statin and overall death (HR = 0.75, 95% CI = 0.63‐0.88) and HNSCC‐specific death (HR = 0.79, 95% CI = 0.63‐0.99) and a nonstatistically significant inverse association for recurrence (HR = 0.85, 95% CI = 0.70‐1.04). When investigating the association between statin use and HNSCC outcomes utilizing interaction terms between statin use and human papillomavirus (HPV), statistically significant interactions for HNSCC‐specific death and recurrence were identified (HNSCC‐specific death: HPV‐positive HR = 0.41, 95% CI = 0.21‐0.84; HPV‐negative HR = 1.04, 95% CI = 0.71‐1.51; p‐int=0.02; recurrence: HPV‐positive HR = 0.49, 95% CI = 0.29‐0.84; HPV‐negative HR = 1.03, 95% CI = 0.74‐1.43; p=int‐0.02). Statin use may be protective for adverse outcomes in HNSCC patients, particularly those with HPV‐positive disease. If true, these findings could have a meaningful impact on tertiary prevention for this cancer.What’s new?For certain cancer types, statin medications reduce the risk of disease development and death, possibly owing to the immune‐modifying or cholesterol‐lowering effects of statins. Whether head and neck squamous cell carcinoma (HNSCC) is among these cancers affected by statins remains unclear. In this study of more than 1600 HNSCC patients, statin use was associated with a reduced overall mortality rate in all patients and with a reduced rate of disease‐specific mortality and disease recurrence specifically among patients with human papillomavirus‐positive tumors. Inverse associations were also observed between statin use and recurrence among participants with disease located in the oropharynx.Publisher
John Wiley & Sons, Inc.
ISSN
0020-7136 1097-0215
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