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Gynecologic Oncology
Association of statins, aspirin, and venous thromboembolism in women with endometrial cancer
Koji Matsuo a,b, , Marianne S. Hom a, Akira Yabuno c, Masako Shida d, Mamoru Kakuda e, Sosuke Adachi f, Rachel S. Mandelbaum a, Yutaka Ueda e, Kosei Hasegawa c, Takayuki Enomoto f, Mikio Mikami d, Lynda D. Roman a,b
a Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
b Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA
c Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama, Japan
d Department of Obstetrics and Gynecology, Tokai University School of Medicine, Kanagawa, Japan
e Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
f Department of Obstetrics and Gynecology, Niigata University School of Medicine, Osaka, Japan
• Association of statins and VTE remains understudied in endometrial cancer.
• Statin use may be associated with decreased risk of VTE in endometrial cancer.
• Obese non-diabetic women may benefit from statin use to reduce VTE risk.
• Women with aggressive tumors may benefit from statin use to reduce VTE risk.
Article history:
Keywords:
Endometrial neoplasms
Hydroxymethylglutaryl-CoA reductase Inhibi-
tors
Aspirin
Venous thromboembolism
Incidence 
Objective. The anti-thrombogenic effects of statins and aspirin have been reported in various malignancies but have not been well examined in endometrial cancer. This study examined the association between statin and/or aspirin use and venous thromboembolism (VTE) risk in endometrial cancer. Methods. This is a multi-center retrospective study examining 2527 women with endometrial cancer be-tween 2000 and 2015. Statin and aspirin use at diagnosis was correlated to VTE risk during follow-up on multi-variable analysis.
Conclusion. Our study suggests Cot1/2 statin use may be associated with decreased risk of VTE in women with endometrial cancer.
Corresponding author at: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, 2020 Zonal Avenue, IRD520, Los Angeles, CA 90033, USA.
E-mail address: [email protected] (K. Matsuo).
1. Introduction
Endometrial cancer continues to be the most common gynecologic malignancy in the United States, with N63,000 women projected to be diagnosed in 2018 [1]. Gynecologic malignancies are associated with an increased risk of venous thromboembolism (VTE) [2–5], and certain groups of women with endometrial cancer harbor a disproportionally high risk (N40%) [6]. VTE can not only result in fatality due to pulmonary thrombosis but also in high treatment-related costs, decreased quality of life due to symptoms or treatment, and increased risk of treatment-related complications. VTE is also a surrogate marker for decreased sur-vival in endometrial cancer [6]. Therefore, any efforts to reduce the risk of VTE will be useful.