Statins and metachronous recurrence after endoscopic resection of early gastric cancer: a nationwide Korean cohort study



Statins have shown to reduce the risk of various cancers. However, their effects on metachronous recurrence (MR) after endoscopic resection (ER) for early gastric cancer (EGC) are unknown. We evaluate their effects on MR development after ER for EGC.


We selected 11,568 patients who received ER for EGC from 2002 to 2011 from the Korean National Health Insurance database and classified into 2 groups: control and statins using propensity score matching. Metachronous recurrence was defined as the second ER or gastrectomy performed 6 months after the first ER.


Mean follow-up period was 8.8 ± 3.1 years. Statins showed a significantly lower incidence of MR than the control group (12.5% vs 2.2%, respectively, P < 0.01). After conducting competing risk analyses and time-dependent cox regression analysis considering immortal time bias, statins still showed a lower incidence rate of MR compared to that observed in the control group. For the multivariate analysis, statins remained significant (HR 0.17; 95% CI 0.13–0.24, P < 0.01). In the dose–response analysis, an inverse dose–response relationship was identified between MR and statins (P < 0.01).


Statins was significantly associated with a reduced risk of MR after ER for EGC with an inverse dose–response relationship.

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Fig. 1
Fig. 2



Average DDD


Body mass index


Confidence intervals


Defined daily dose


Early gastric cancer


Endoscopic mucosal resection


Endoscopic resection


Endoscopic submucosal dissection

H. pylori :

Helicobacter pylori


Hazard ratio


International classification of disease 10th revision


Korean Central Cancer Registry


National Health Insurance Service


Metachronous recurrence


Odds ratio


Propensity score-matching


Standard deviation


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The authors thank the staff of the National Health Insurance Service.

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Corresponding authors

Correspondence to Sang Kil Lee or Sang Gyun Kim.

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Chung, H., Kim, H.J., Jung, H.C. et al. Statins and metachronous recurrence after endoscopic resection of early gastric cancer: a nationwide Korean cohort study. Gastric Cancer 23, 659–666 (2020).

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  • Medication
  • Recurrence
  • Stomach neoplasm
  • Endoscopic treatment