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First page of Effect of Statin Use on Survival Outcomes in Patients Diagnosed with Epithelial Ovarian Cancer

Introduction: Patients diagnosed with epithelial ovarian cancer (EOC) usually experience a poor prognosis with a 5-year survival rate of approximately 40%. Thus, there would be an interest in a new perspective on the anticancer action of statins on survival outcomes in patients with EOC. This study aimed to assess the effect of statin on survival outcomes in patients diagnosed with EOC. Methods: A retrospective cohort study was conducted on EOC patients scheduled for cytoreductive surgery at Rajavithi Hospital between January 2012 and December 2016. Data on statin use before being diagnosed with EOC and cancer treatment were extracted from medical records. Survival outcomes, including progression-free survival (PFS) and overall survival (OS), were analyzed using the Kaplan-Meier method and log-rank test, comparing statin users and non-users. The Cox proportional hazards model was employed to estimate hazard ratios (HR) and 95% confidence intervals (95%CI) to determine the association between statin use and survival outcomes. Results: A total of 477 EOC patients met the inclusion criteria. Among them, 76 (15.9%) were statin users, while 401 (84.1%) were non-users. Over a median follow-up of 59 months, 210 patients (44%) experienced disease recurrence, and 197 (41.3%) succumbed to EOC. There was no statistically significant difference between statin users and non-users between 5-year PFS (45.1% vs. 56.1%, p=0.295) or 5-year OS (50.8% vs. 55.3%, p=0.590). Multivariate Cox analysis identified advanced cancer stage and optimal surgery as independent prognostic factors for PFS and OS. However, statin uses did not significantly impact PFS (adjusted HR 1.09; 95%CI 0.73,1.64) or OS (adjusted HR 0.84; 95%CI 0.56,1.27). Conclusion: Statin use was not associated with improved survival outcomes in patients with EOC. Future research, preferably through prospective randomized control trials, is warranted to minimize selection bias and further explore the potential benefits of statin in this context.

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