SynthesisInternational journal of colorectal disease2021

Concurrent use of statins and neoadjuvant chemoradiotherapy for rectal cancer: a systematic review and meta-analysis.

Tyler McKechnie, Gaurav Talwar, Yung Lee, Oren Levine, Cagla Eskicioglu

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in International journal of colorectal disease, 2021. The graph read 2 numbers from its abstract, feeding 1 cell of the map, but none could be read as for or against, so it casts no vote. Not yet cited in PubMed.

2numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.3field-weighted citation impact, top 41% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

Read, but not usablea number the graph found but could not read as for or against

All-cause mortalitycomparator not stated · ascvdfeeds one cell of the map
RR 1.040.85 to 1.26p = 0.73
Similarly, no difference existed between groups in long-term oncologic outcomes (5-year overall survival: RR 1.03, 95%CI 0.86-1.24, p = 0.75; 5-year disease-free survival: RR 1.04, 95%CI 0.85-1.26, p = 0.73).
All-cause mortalitycomparator not stated · ascvdfeeds one cell of the map
RR 1.030.86 to 1.24p = 0.75
Similarly, no difference existed between groups in long-term oncologic outcomes (5-year overall survival: RR 1.03, 95%CI 0.86-1.24, p = 0.75; 5-year disease-free survival: RR 1.04, 95%CI 0.85-1.26, p = 0.73).

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

Statins×all-cause mortality

No readable resultOpen on the map →What to test next →

13 readable studies in this cell: 4 favour the treatment, 8 find no difference, 1 favour the comparator.

Belief with this paper
0.50contested · 3 families support, 2 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
1 · no effect
NCT023442907,769 enrolled · 2015
HR 0.880.70 to 1.12
HR 1.000.90 to 1.12
NCT03944512102 enrolled · 2019
RR 0.670.37 to 1.19
RR 0.990.89 to 1.11

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

4 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

5 · Its place in the literature

Who cites it

0 citing papers in PubMed, 3 citations in OpenAlex.

No citing paper in PubMed yet.

6 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

7 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Tyler McKechnieMichael G. DeGroote School of Medicine, McMaster University, 1280 Main St. W, Hamilton, ON, L8S 4L8, Canada.
Gaurav Talwar
Yung LeeMichael G. DeGroote School of Medicine, McMaster University, 1280 Main St. W, Hamilton, ON, L8S 4L8, Canada.
Oren LevineMichael G. DeGroote School of Medicine, McMaster University, 1280 Main St. W, Hamilton, ON, L8S 4L8, Canada.
Cagla EskiciogluMichael G. DeGroote School of Medicine, McMaster University, 1280 Main St. W, Hamilton, ON, L8S 4L8, Canada. eskicio@mcmaster.ca.ORCID http://orcid.org/0000-0003-3920-066X
McMaster University · CAMcMaster University Medical Centre · CASt. Joseph’s Healthcare Hamilton · CA

Funding

No grant is acknowledged in the PubMed record.

8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

purposeStatins are used primarily in patients with cardiovascular disease. More recently, they have demonstrated benefit in oncology patients. In vitro models have shown decreased rectal tumor cell viability in cells receiving chemoradiation and statin therapy. In vivo models have been less clear. This study aims to elucidate the impact of concurrent use of statins on the efficacy of neoadjuvant therapy for rectal cancer.

methodsSearch of Medline, EMBASE, and CENTRAL was performed. Articles were included if they reported complete pathological response (pCR), long-term oncologic outcomes, or chemoradiotherapy-induced toxicity in patients with rectal cancer receiving concurrent statin and neoadjuvant therapy. A pairwise meta-analyses was performed using inverse variance random effects.

resultsFrom 1564 citations, six studies with 726 patients on statin therapy (24.5% female, age: 63.6 years) and 1863 patients not on statin therapy (35.6% female, age: 60.9 years) were included. There was no significant difference in pCR rate between patients on statin therapy and patients not on statin therapy (RR 1.23, 95%CI 0.98-1.54, p = 0.08). Similarly, no difference existed between groups in long-term oncologic outcomes (5-year overall survival: RR 1.03, 95%CI 0.86-1.24, p = 0.75; 5-year disease-free survival: RR 1.04, 95%CI 0.85-1.26, p = 0.73). Chemoradiotherapy-induced toxicities were similar between groups.

conclusionThe concurrent use of statin and neoadjuvant therapy did not significantly impact short- or long-term oncologic outcomes in patients with rectal cancer. Yet, despite pooling of data, this study remained inadequately powered. Larger, prospective studies are required to further elucidate the impact of statins on patients undergoing neoadjuvant therapy for rectal cancer.

Indexed as

Cardiovascular DiseasesHydroxymethylglutaryl-CoA Reductase InhibitorsRectal NeoplasmsChemoradiotherapyFemaleHumansMaleMiddle AgedNeoadjuvant TherapyHydroxymethylglutaryl-CoA Reductase InhibitorsChemoradiotherapyColorectal neoplasmsHydroxymethylglutaryl-CoA reductase inhibitorsNeoadjuvant therapyRectal neoplasmsSurgical oncology

Identifiers

PMID34498133
OpenAlexW3197633965

What OpenQuestion holds

Texttitle and abstract
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.