292 DOES INITIATING STATIN THERAPY AFTER RADICAL PROSTATECTOMY REDUCE THE RISK FOR BIOCHEMICAL RECURRENCE? – RESULTS FROM THE SEARCH DATABASE

Abstract

You have accessJournal of UrologyProstate Cancer: Localized I1 Apr 2010292 DOES INITIATING STATIN THERAPY AFTER RADICAL PROSTATECTOMY REDUCE THE RISK FOR BIOCHEMICAL RECURRENCE? – RESULTS FROM THE SEARCH DATABASE Lionel Bañez, Leah Gerber, William Aronson, Joseph Presti, Martha Terris, Christopher Amling, Christopher Kane, and Stephen Freedland Lionel BañezLionel Bañez Durham, NC More articles by this author , Leah GerberLeah Gerber Durham, NC More articles by this author , William AronsonWilliam Aronson Los Angeles, CA More articles by this author , Joseph PrestiJoseph Presti Palo Alto, CA More articles by this author , Martha TerrisMartha Terris Augusta, GA More articles by this author , Christopher AmlingChristopher Amling Portland, OR More articles by this author , Christopher KaneChristopher Kane San Diego, CA More articles by this author , and Stephen FreedlandStephen Freedland Durham, NC More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.354AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Preclinical and epidemiological evidence both suggest that statin medications may slow prostate cancer (CaP) progression though controversy remains. More recently, statin intake before surgery was found to be associated with decreased risk for adverse pathological features, tumor inflammation and PSA recurrence in men undergoing radical prostatectomy (RP). Because men at risk for cardiovascular disease are likely to be prescribed a statin regardless of CaP status, a more clinically relevant problem is determining whether men not requiring statin-related cardiovascular risk reduction should be prescribed a statin after being diagnosed with or treated for CaP. However, whether statin intake after RP influences the risk for biochemical recurrence has not been investigated. METHODS Data from 1,280 men treated with RP who were not on any statin medication prior to surgery within the Shared Equal Access Regional Cancer Hospital (SEARCH) database were used for analysis. Time to PSA recurrence was compared between statin-users and non-users using Cox proportional hazards models adjusted for demographic and clinicopathological factors including disease severity at RP. To account for differences in time interval between RP and start of statin therapy, statin use was treated as a time-varying covariate in multivariable analyses. RESULTS Among men not on a statin at the time of surgery, 350 men (27%) began statin therapy after RP. Overall, post-RP statin users had lower mean age (61.5 vs. 62.8 years; p=0.002), higher median body mass index (27.5 vs. 27.0 kg/m2; p=0.04) and lower median pre-operative PSA levels (6.5 vs. 7.8 ng/ml; p<0.001) compared to non-users. After controlling for clinical and pathological parameters, post-RP statin use was significantly associated with lower risk for biochemical recurrence (HR 0.61; 95% CI 0.40-0.93, p=0.02; see Figure). CONCLUSIONS Initiating statin therapy after RP was associated with a 39% reduction in the risk for PSA recurrence among men who underwent RP. If confirmed in larger studies, prospective randomized trials to establish whether statins have a role in preventing or delaying biochemical relapse, metastasis and CaP-specific death are warranted. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e115-e116 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Lionel Bañez Durham, NC More articles by this author Leah Gerber Durham, NC More articles by this author William Aronson Los Angeles, CA More articles by this author Joseph Presti Palo Alto, CA More articles by this author Martha Terris Augusta, GA More articles by this author Christopher Amling Portland, OR More articles by this author Christopher Kane San Diego, CA More articles by this author Stephen Freedland Durham, NC More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...