ArticleJournal of gastrointestinal oncology2026
Association between preoperative statin use and survival after pylorus-preserving pancreaticoduodenectomy for pancreatic or periampullary cancer: a propensity score-matched cohort study.
Article in Journal of gastrointestinal oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Beyond their primary lipid-lowering role, statins exert pleiotropic properties such as anti-inflammatory and endothelial-stabilizing effects. In this study, we investigated whether preoperative statin exposure was associated with postoperative survival outcomes and disease-free survival (DFS) in patients undergoing pylorus-preserving pancreaticoduodenectomy (PPPD) for pancreatic or periampullary malignancies. Methods: We retrospectively analyzed patients who underwent PPPD at a tertiary center between 2012 and 2016. Short-term (1-year) and long-term outcomes, including 5-year mortality, overall mortality, and DFS, were compared between statin users and nonusers. To minimize baseline imbalance, 1:2 propensity score (PS) matching was performed using a model that incorporated demographic, clinical, and major pathologic prognostic factors, including age, sex, comorbidities, tumor location, tumor-node-metastasis (TNM) stage, resection margin status, lymph-node ratio, tumor grade, and carbohydrate antigen 19-9 (CA19-9). Cox proportional hazards regression was used to assess associations between statin use and outcomes. Results: Among 718 patients, 130 (18.1%) received preoperative statins. After 1:2 matching, 116 statin users and 193 nonusers were analyzed. One-year, 5-year, and overall mortality did not differ significantly between groups before or after matching, and preoperative statin use was not independently associated with 5-year or overall mortality [5-year mortality: adjusted hazard ratio (HR), 0.96, 95% confidence interval (CI), 0.72-1.27; PS-matched HR, 1.09, 95% CI, 0.80-1.49]. Although a lower 1-year mortality was observed after multivariable adjustment, this association was not significant in the crude or PS-matched analyses. DFS likewise showed no significant difference at any outcome in either unadjusted or adjusted analyses. Conclusions: Preoperative statin use was not associated with short-term or long-term survival or oncologic outcomes after PPPD.
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