Statin Use and the Risk of Recurrence After Radical Prostatectomy

MB Ishak-Howard, LA Okoth, KA Cooney

Carcinoma ProstataABSTRACT

OBJECTIVE
To investigate whether the use of statin medications is associated with a reduced risk of biochemical recurrence (BCR) in men with inherited and/or early-onset prostate cancer who have been treated with radical retropubic prostatectomy (RRP).

METHODS
Study patients are men with inherited and/or early-onset prostate cancer enrolled in the University of Michigan Prostate Cancer Genetics Project. Men enrolled in Prostate Cancer Genetics Project were surveyed to determine statin medication use history from 1999 to 2009. Diagnosis and treatment data were taken from medical records. BCR was defined as a single increase in prostate-specific antigen level to ≥0.4 ng/mL after treatment with RRP. Statin use was modeled as a time-dependent variable, and BCR after RRP was both examined using crude Cox proportional hazards models and adjusted for known clinical prognostic factors.

RESULTS
A total of 539 men treated with RRP were included in this study. Of these, 47.9% of men used statin medications, and 115 (21%) men experienced a recurrence. Ever-statin use was not associated with risk of recurrence in crude models (hazards ratio = 1.04, 95% confidence interval = 0.72-1.49, P value = .86) or in models adjusted for clinical characteristics (hazards ratio = 1.06, 95% confidence interval = 0.68-1.64, P value = .81). Furthermore, no association was observed when comparing men with high-Gleason grade cancers with those with low-Gleason grade cancers.

CONCLUSION
Statin use was not associated with a reduced risk of BCR after RRP in this study; however, these men at increased risk for prostate cancer represent a subgroup of men who may benefit from further study of statin medication use to slow or prevent BCR.

MB Ishak-Howard, LA Okoth, KA Cooney
Statin Use and the Risk of Recurrence After Radical Prostatectomy in a Cohort of Men With Inherited and/or Early-Onset Forms of Prostate Cancer
Urology 2014 Jun 01;83(6)1356-1361,