Putsarat Insin

Association of preoperative serum HE4 levels on the survival of patients with endometrial cancer

To evaluate the association between preoperative serum human epididymis protein 4 (HE4) levels and survival outcomes in endometrial cancer (EC) patients. A retrospective cohort study was conducted of EC patients who were scheduled for surgery between September 2013 and May 2014 at Rajavithi Hospital. Association between preoperative serum HE4 levels and clinicopathological characteristics were evaluated. Cox proportional-hazards model was used to compare overall survival (OS) and recurrence-free survival (RFS) between EC patients who had high serum HE4 levels and those who did not. A total of 86 EC patients were enrolled. Serum HE4 levels was significantly associated with older age (p < 0.001), postmenopausal women (p = 0.001), large tumor size (p < 0.001), presence of lymphovascular invasion (p = 0.022), deep myometrial invasion (p = 0.001), lymph node metastasis (0.017), high-risk group (p < 0.001), and death status (p = 0.002). With a median follow-up of 53 months, the 3-years OS and PFS of EC patients who had high serum HE4 levels were significantly poorer than those who did not (71% vs 95.8%, and 67.7% vs 91.7%, respectively). A high serum HE4 level was a significant prognostic factor for OS and RFS from the univariate analysis. However, it was not a significant prognostic factor in the multivariate analysis. Preoperative high serum HE4 levels were significantly associated with the worse clinicopathological characteristic of EC patients and decreased OS and RFS. Although there was no strong independent prognostic factor for survival, serum HE4 levels could be used in an algorithm for stratifying high-risk EC patients with more proper management.

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 (HRs) and 95% confidence intervals (95% CIs) 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) and 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.