Outcomes of statin use in veterans with prostate cancer: A retrospective single-center experience.

Abstract

e17612 Background: Prostate cancer is the most common cancer in men in the United States. Death in prostate cancer patients is often reported to be non-prostate cancer related, attributed to other medical conditions. As prostate cancer is associated with a prolonged survival, care of these patients includes optimizing other co-morbidities, such as cardiovascular disease. There are multiple reports and epidemiological studies of statins decreasing the risk, progression, and overall mortality of prostate cancer. Previously we had gathered data on 300 patients diagnosed with prostate cancer at the VA in San Antonio. The results indicated that using statins has a statistically significant positive effect at delaying death by prostate cancer, with a p-value of 0.018. We have updated our results with the addition of 105 patients. Methods: This is a retrospective observational study with chart review of 405 patients diagnosed with prostate cancer from 1995 to 2010, in a VA Hospital in San Antonio, Texas. Variables included age of diagnosis, statin use, type of statin (1st, 2nd, or 3rd generation), dose of statin (6 levels of dosage were identified), length of statin use, time followed in months (from time of diagnosis to either death or the end of the study period), death, and cause of death. The Cox proportional hazards regression model was used to estimate the hazard function, with age at diagnosis used as a covariate. Primary end point was death by prostate cancer (33 patients) and secondary end points- death by any cancer (71 patients), and death by all causes (205 patients). Results: The hazard ratio for use of statins at least 6 months was 0.56, with 95% confidence limits of 0.41 to 1.13, and a p-value of 0.118, indicating no statistically significant effect of statin usage and delay in death by prostate cancer. Secondary endpoint of death by all causes was significantly affected by statins, while death by any cancer showed no significant effect. The study was unable to conclude if the type of statin, dose of statin or the length of statin use had a significant effect in reaching the different end points. Conclusions: The addition of 105 more patients to this study has changed our previous statistically significant primary endpoint results.Concomitant statin use may not help prevent death from prostate cancer or death from any cancer, but may help prevent death from all causes. This updated primary endpoint data conflicts with multiple prior epidemiological studies and raises questions on the impact of statin usage on men with prostate cancer.