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Statin use after radical prostatectomy reduces biochemical recurrence in men with prostate cancer
Author(s) -
Song Cheryn,
Park Sejun,
Park Jinsung,
Shim Myungsun,
Kim Aram,
Jeong In Gab,
Hong Jun Hyuk,
Kim ChoungSoo,
Ahn Hanjong
Publication year - 2015
Publication title -
the prostate
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.295
H-Index - 123
eISSN - 1097-0045
pISSN - 0270-4137
DOI - 10.1002/pros.22907
Subject(s) - medicine , biochemical recurrence , prostate cancer , prostatectomy , statin , urology , stage (stratigraphy) , proportional hazards model , multivariate analysis , cancer , surgical margin , gastroenterology , surgery , paleontology , biology
BACKGROUND The impact of statin use on biochemical recurrence (BCR) of prostate cancer after radical prostatectomy (RP) is controversial. METHODS In 2,137 consecutive RP patients between 1998 and 2011 at Asan Medical Center, we aimed to assess the presence and impact of statin use according to types (hydrophilic vs. hydrophobic), dose equivalents (DEs), and postoperative duration of usage (<18, 18–36, >36 months). Between non‐users and preoperative or postoperative users, clinicopathological characteristics, and impact of statin use on BCR were analyzed using Cox proportional hazards model. Mean (range) follow‐up was 39.4 (8–183) months. RESULTS Compared to non‐users, preoperative users had lower PSA (5.8 vs. 7 ng/ml), but the rates of organ confined disease, pathologic Gleason score (GS) or positive surgical margin (PSM) were not different. After adjusting for pathologic stage, postoperative statin use was associated with a higher BCR‐free survival. In multivariate analysis, ≤36 months' statin use independently decreased the risk of BCR along with PSA, pathologic GS, pathologic stage, and PSM. Risk reduction was observed especially in patients with pathologic GS ≥ 7 (HR 0.27, 95% CI 0.13–0.59, P = 0.001), NSM disease (HR 0.18, 95% CI 0.05–0.63, P = 0.007), or PSA ≥ 10.0 ng/ml (HR 0.30, 95% CI 0.11–0.81, P = 0.018). Increasing duration of use nullified the effect. Preoperative statin use did not demonstrate significant risk reduction for BCR in any of the stratified multivariate models. CONCLUSION In Korean men undergoing RP, preoperative statin use was not associated with different pathologic outcome. However, postoperative statin use until 36 months decreased the risk of BCR independently especially in patients with high‐risk disease. Prostate 75:211–217, 2015 . © 2014 Wiley Periodicals, Inc.