Postoperative statin use and risk of biochemical recurrence following radical prostatectomy: Results from the Shared Equal Access Regional Cancer Hospital (SEARCH) database

Emma H. Allott, Lauren E. Howard, Matthew R. Cooperberg, Christopher J. Kane, William J. Aronson, Martha Kennedy Terris, Christopher L. Amling, Stephen J. Freedland

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Objective To investigate the effect of statin use after radical prostatectomy (RP) on biochemical recurrence (BCR) in patients with prostate cancer who never received statins before RP. Patients and Methods We conducted a retrospective analysis of 1146 RP patients within the Shared Equal Access Regional Cancer Hospital (SEARCH) database. Multivariable Cox proportional hazards analyses were used to examine differences in risk of BCR between post-RP statin users vs nonusers. To account for varying start dates and duration of statin use during follow-up, post-RP statin use was treated as a time-dependent variable. In a secondary analysis, models were stratified by race to examine the association of post-RP statin use with BCR among black and non-black men. Results After adjusting for clinical and pathological characteristics, post-RP statin use was significantly associated with 36% reduced risk of BCR (hazard ratio [HR] 0.64, 95% confidence interval [CI] 0.47-0.87; P = 0.004). Post-RP statin use remained associated with reduced risk of BCR after adjusting for preoperative serum cholesterol levels. In secondary analysis, after stratification by race, this protective association was significant in non-black (HR 0.49, 95% CI 0.32-0.75; P = 0.001) but not black men (HR 0.82, 95% CI 0.53-1.28; P = 0.384). Conclusion In this retrospective cohort of men undergoing RP, post-RP statin use was significantly associated with reduced risk of BCR. Whether the association between post-RP statin use and BCR differs by race requires further study. Given these findings, coupled with other studies suggesting that statins may reduce risk of advanced prostate cancer, randomised controlled trials are warranted to formally test the hypothesis that statins slow prostate cancer progression.

Original languageEnglish (US)
Pages (from-to)661-666
Number of pages6
JournalBJU International
Volume114
Issue number5
DOIs
StatePublished - Nov 1 2014

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Cancer Care Facilities
Prostatectomy
Databases
Recurrence
Prostatic Neoplasms
Confidence Intervals

Keywords

  • biochemical recurrence
  • cholesterol
  • postoperative statin use
  • prostate cancer

ASJC Scopus subject areas

  • Urology

Cite this

Postoperative statin use and risk of biochemical recurrence following radical prostatectomy : Results from the Shared Equal Access Regional Cancer Hospital (SEARCH) database. / Allott, Emma H.; Howard, Lauren E.; Cooperberg, Matthew R.; Kane, Christopher J.; Aronson, William J.; Terris, Martha Kennedy; Amling, Christopher L.; Freedland, Stephen J.

In: BJU International, Vol. 114, No. 5, 01.11.2014, p. 661-666.

Research output: Contribution to journalArticle

Allott, Emma H. ; Howard, Lauren E. ; Cooperberg, Matthew R. ; Kane, Christopher J. ; Aronson, William J. ; Terris, Martha Kennedy ; Amling, Christopher L. ; Freedland, Stephen J. / Postoperative statin use and risk of biochemical recurrence following radical prostatectomy : Results from the Shared Equal Access Regional Cancer Hospital (SEARCH) database. In: BJU International. 2014 ; Vol. 114, No. 5. pp. 661-666.
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title = "Postoperative statin use and risk of biochemical recurrence following radical prostatectomy: Results from the Shared Equal Access Regional Cancer Hospital (SEARCH) database",
abstract = "Objective To investigate the effect of statin use after radical prostatectomy (RP) on biochemical recurrence (BCR) in patients with prostate cancer who never received statins before RP. Patients and Methods We conducted a retrospective analysis of 1146 RP patients within the Shared Equal Access Regional Cancer Hospital (SEARCH) database. Multivariable Cox proportional hazards analyses were used to examine differences in risk of BCR between post-RP statin users vs nonusers. To account for varying start dates and duration of statin use during follow-up, post-RP statin use was treated as a time-dependent variable. In a secondary analysis, models were stratified by race to examine the association of post-RP statin use with BCR among black and non-black men. Results After adjusting for clinical and pathological characteristics, post-RP statin use was significantly associated with 36{\%} reduced risk of BCR (hazard ratio [HR] 0.64, 95{\%} confidence interval [CI] 0.47-0.87; P = 0.004). Post-RP statin use remained associated with reduced risk of BCR after adjusting for preoperative serum cholesterol levels. In secondary analysis, after stratification by race, this protective association was significant in non-black (HR 0.49, 95{\%} CI 0.32-0.75; P = 0.001) but not black men (HR 0.82, 95{\%} CI 0.53-1.28; P = 0.384). Conclusion In this retrospective cohort of men undergoing RP, post-RP statin use was significantly associated with reduced risk of BCR. Whether the association between post-RP statin use and BCR differs by race requires further study. Given these findings, coupled with other studies suggesting that statins may reduce risk of advanced prostate cancer, randomised controlled trials are warranted to formally test the hypothesis that statins slow prostate cancer progression.",
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T1 - Postoperative statin use and risk of biochemical recurrence following radical prostatectomy

T2 - Results from the Shared Equal Access Regional Cancer Hospital (SEARCH) database

AU - Allott, Emma H.

AU - Howard, Lauren E.

AU - Cooperberg, Matthew R.

AU - Kane, Christopher J.

AU - Aronson, William J.

AU - Terris, Martha Kennedy

AU - Amling, Christopher L.

AU - Freedland, Stephen J.

PY - 2014/11/1

Y1 - 2014/11/1

N2 - Objective To investigate the effect of statin use after radical prostatectomy (RP) on biochemical recurrence (BCR) in patients with prostate cancer who never received statins before RP. Patients and Methods We conducted a retrospective analysis of 1146 RP patients within the Shared Equal Access Regional Cancer Hospital (SEARCH) database. Multivariable Cox proportional hazards analyses were used to examine differences in risk of BCR between post-RP statin users vs nonusers. To account for varying start dates and duration of statin use during follow-up, post-RP statin use was treated as a time-dependent variable. In a secondary analysis, models were stratified by race to examine the association of post-RP statin use with BCR among black and non-black men. Results After adjusting for clinical and pathological characteristics, post-RP statin use was significantly associated with 36% reduced risk of BCR (hazard ratio [HR] 0.64, 95% confidence interval [CI] 0.47-0.87; P = 0.004). Post-RP statin use remained associated with reduced risk of BCR after adjusting for preoperative serum cholesterol levels. In secondary analysis, after stratification by race, this protective association was significant in non-black (HR 0.49, 95% CI 0.32-0.75; P = 0.001) but not black men (HR 0.82, 95% CI 0.53-1.28; P = 0.384). Conclusion In this retrospective cohort of men undergoing RP, post-RP statin use was significantly associated with reduced risk of BCR. Whether the association between post-RP statin use and BCR differs by race requires further study. Given these findings, coupled with other studies suggesting that statins may reduce risk of advanced prostate cancer, randomised controlled trials are warranted to formally test the hypothesis that statins slow prostate cancer progression.

AB - Objective To investigate the effect of statin use after radical prostatectomy (RP) on biochemical recurrence (BCR) in patients with prostate cancer who never received statins before RP. Patients and Methods We conducted a retrospective analysis of 1146 RP patients within the Shared Equal Access Regional Cancer Hospital (SEARCH) database. Multivariable Cox proportional hazards analyses were used to examine differences in risk of BCR between post-RP statin users vs nonusers. To account for varying start dates and duration of statin use during follow-up, post-RP statin use was treated as a time-dependent variable. In a secondary analysis, models were stratified by race to examine the association of post-RP statin use with BCR among black and non-black men. Results After adjusting for clinical and pathological characteristics, post-RP statin use was significantly associated with 36% reduced risk of BCR (hazard ratio [HR] 0.64, 95% confidence interval [CI] 0.47-0.87; P = 0.004). Post-RP statin use remained associated with reduced risk of BCR after adjusting for preoperative serum cholesterol levels. In secondary analysis, after stratification by race, this protective association was significant in non-black (HR 0.49, 95% CI 0.32-0.75; P = 0.001) but not black men (HR 0.82, 95% CI 0.53-1.28; P = 0.384). Conclusion In this retrospective cohort of men undergoing RP, post-RP statin use was significantly associated with reduced risk of BCR. Whether the association between post-RP statin use and BCR differs by race requires further study. Given these findings, coupled with other studies suggesting that statins may reduce risk of advanced prostate cancer, randomised controlled trials are warranted to formally test the hypothesis that statins slow prostate cancer progression.

KW - biochemical recurrence

KW - cholesterol

KW - postoperative statin use

KW - prostate cancer

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