Statin medication use and the risk of biochemical recurrence after radical prostatectomy: Results from the Shared Equal Access Regional Cancer Hospital (SEARCH) database

Robert J. Hamilton, Lionel L. Banez, William J. Aronson, Martha K. Terris, Elizabeth A. Platz, Christopher J. Kane, Joseph C. Presti, Christopher L. Amling, Stephen J. Freedland

Research output: Contribution to journalArticle

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Abstract

BACKGROUND: Although controversial, evidence suggests statins may reduce the risk of advanced prostate cancer (PC), and recently statin use was associated with prostate-specific antigen (PSA) reductions among men without PC. The authors sought to examine the association between statin use and PSA recurrence after radical prostatectomy (RP). METHODS: The authors examined 1319 men treated with RP from the Shared Equal Access Regional Cancer Hospital (SEARCH) Database. Time to PSA recurrence was compared between users and nonusers of statin at surgery using Cox proportional hazards models adjusted for multiple clinical and pathological features. RESULTS: In total, 236 (18%) men were taking statins at RP. Median follow-up was 24 months for statin users and 38 for nonusers. Statin users were older (P < .001) and underwent RP more recently (P < .001). Statin users were diagnosed at lower clinical stages (P = .009) and with lower PSA levels (P = .04). However, statin users tended to have higher biopsy Gleason scores (P = .002). After adjusting for multiple clinical and pathological factors, statin use was associated with a 30% lower risk of PSA recurrence (hazard ratio "HR", 0.70; 95% confidence interval "CI", 0.50-0.97; P = .03), which was dose dependent (relative to no statin use; dose equivalent<simvastatin 20 mg: HR, 1.08; 95% CI, 0.66-1.73; P = .78; dose equivalent = simvastatin 20 mg: HR, 0.57; 95% CI, 0.32-1.00; P = .05; dose equivalent>simvastatin 20 mg: HR, 0.50; 95% CI, 0.27-0.93; P = .03). CONCLUSIONS: In this cohort of men undergoing RP, statin use was associated with a dose-dependent reduction in the risk of biochemical recurrence. If confirmed in other studies, these findings suggest statins may slow PC progression after RP.

Original languageEnglish (US)
Pages (from-to)3389-3398
Number of pages10
JournalCancer
Volume116
Issue number14
DOIs
StatePublished - Jul 15 2010

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Cancer Care Facilities
Prostatectomy
Databases
Recurrence
Prostate-Specific Antigen
Prostatic Neoplasms
Simvastatin
Risk Reduction Behavior
Proportional Hazards Models

Keywords

  • Hydroxymethylglutaryl-coenzyme A reductase inhibitors
  • Prostate neoplasms
  • Radical prostatectomy
  • Statins

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Statin medication use and the risk of biochemical recurrence after radical prostatectomy : Results from the Shared Equal Access Regional Cancer Hospital (SEARCH) database. / Hamilton, Robert J.; Banez, Lionel L.; Aronson, William J.; Terris, Martha K.; Platz, Elizabeth A.; Kane, Christopher J.; Presti, Joseph C.; Amling, Christopher L.; Freedland, Stephen J.

In: Cancer, Vol. 116, No. 14, 15.07.2010, p. 3389-3398.

Research output: Contribution to journalArticle

Hamilton, Robert J. ; Banez, Lionel L. ; Aronson, William J. ; Terris, Martha K. ; Platz, Elizabeth A. ; Kane, Christopher J. ; Presti, Joseph C. ; Amling, Christopher L. ; Freedland, Stephen J. / Statin medication use and the risk of biochemical recurrence after radical prostatectomy : Results from the Shared Equal Access Regional Cancer Hospital (SEARCH) database. In: Cancer. 2010 ; Vol. 116, No. 14. pp. 3389-3398.
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abstract = "BACKGROUND: Although controversial, evidence suggests statins may reduce the risk of advanced prostate cancer (PC), and recently statin use was associated with prostate-specific antigen (PSA) reductions among men without PC. The authors sought to examine the association between statin use and PSA recurrence after radical prostatectomy (RP). METHODS: The authors examined 1319 men treated with RP from the Shared Equal Access Regional Cancer Hospital (SEARCH) Database. Time to PSA recurrence was compared between users and nonusers of statin at surgery using Cox proportional hazards models adjusted for multiple clinical and pathological features. RESULTS: In total, 236 (18{\%}) men were taking statins at RP. Median follow-up was 24 months for statin users and 38 for nonusers. Statin users were older (P < .001) and underwent RP more recently (P < .001). Statin users were diagnosed at lower clinical stages (P = .009) and with lower PSA levels (P = .04). However, statin users tended to have higher biopsy Gleason scores (P = .002). After adjusting for multiple clinical and pathological factors, statin use was associated with a 30{\%} lower risk of PSA recurrence (hazard ratio {"}HR{"}, 0.70; 95{\%} confidence interval {"}CI{"}, 0.50-0.97; P = .03), which was dose dependent (relative to no statin use; dose equivalentsimvastatin 20 mg: HR, 0.50; 95{\%} CI, 0.27-0.93; P = .03). CONCLUSIONS: In this cohort of men undergoing RP, statin use was associated with a dose-dependent reduction in the risk of biochemical recurrence. If confirmed in other studies, these findings suggest statins may slow PC progression after RP.",
keywords = "Hydroxymethylglutaryl-coenzyme A reductase inhibitors, Prostate neoplasms, Radical prostatectomy, Statins",
author = "Hamilton, {Robert J.} and Banez, {Lionel L.} and Aronson, {William J.} and Terris, {Martha K.} and Platz, {Elizabeth A.} and Kane, {Christopher J.} and Presti, {Joseph C.} and Amling, {Christopher L.} and Freedland, {Stephen J.}",
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T1 - Statin medication use and the risk of biochemical recurrence after radical prostatectomy

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

AU - Hamilton, Robert J.

AU - Banez, Lionel L.

AU - Aronson, William J.

AU - Terris, Martha K.

AU - Platz, Elizabeth A.

AU - Kane, Christopher J.

AU - Presti, Joseph C.

AU - Amling, Christopher L.

AU - Freedland, Stephen J.

PY - 2010/7/15

Y1 - 2010/7/15

N2 - BACKGROUND: Although controversial, evidence suggests statins may reduce the risk of advanced prostate cancer (PC), and recently statin use was associated with prostate-specific antigen (PSA) reductions among men without PC. The authors sought to examine the association between statin use and PSA recurrence after radical prostatectomy (RP). METHODS: The authors examined 1319 men treated with RP from the Shared Equal Access Regional Cancer Hospital (SEARCH) Database. Time to PSA recurrence was compared between users and nonusers of statin at surgery using Cox proportional hazards models adjusted for multiple clinical and pathological features. RESULTS: In total, 236 (18%) men were taking statins at RP. Median follow-up was 24 months for statin users and 38 for nonusers. Statin users were older (P < .001) and underwent RP more recently (P < .001). Statin users were diagnosed at lower clinical stages (P = .009) and with lower PSA levels (P = .04). However, statin users tended to have higher biopsy Gleason scores (P = .002). After adjusting for multiple clinical and pathological factors, statin use was associated with a 30% lower risk of PSA recurrence (hazard ratio "HR", 0.70; 95% confidence interval "CI", 0.50-0.97; P = .03), which was dose dependent (relative to no statin use; dose equivalentsimvastatin 20 mg: HR, 0.50; 95% CI, 0.27-0.93; P = .03). CONCLUSIONS: In this cohort of men undergoing RP, statin use was associated with a dose-dependent reduction in the risk of biochemical recurrence. If confirmed in other studies, these findings suggest statins may slow PC progression after RP.

AB - BACKGROUND: Although controversial, evidence suggests statins may reduce the risk of advanced prostate cancer (PC), and recently statin use was associated with prostate-specific antigen (PSA) reductions among men without PC. The authors sought to examine the association between statin use and PSA recurrence after radical prostatectomy (RP). METHODS: The authors examined 1319 men treated with RP from the Shared Equal Access Regional Cancer Hospital (SEARCH) Database. Time to PSA recurrence was compared between users and nonusers of statin at surgery using Cox proportional hazards models adjusted for multiple clinical and pathological features. RESULTS: In total, 236 (18%) men were taking statins at RP. Median follow-up was 24 months for statin users and 38 for nonusers. Statin users were older (P < .001) and underwent RP more recently (P < .001). Statin users were diagnosed at lower clinical stages (P = .009) and with lower PSA levels (P = .04). However, statin users tended to have higher biopsy Gleason scores (P = .002). After adjusting for multiple clinical and pathological factors, statin use was associated with a 30% lower risk of PSA recurrence (hazard ratio "HR", 0.70; 95% confidence interval "CI", 0.50-0.97; P = .03), which was dose dependent (relative to no statin use; dose equivalentsimvastatin 20 mg: HR, 0.50; 95% CI, 0.27-0.93; P = .03). CONCLUSIONS: In this cohort of men undergoing RP, statin use was associated with a dose-dependent reduction in the risk of biochemical recurrence. If confirmed in other studies, these findings suggest statins may slow PC progression after RP.

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KW - Prostate neoplasms

KW - Radical prostatectomy

KW - Statins

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