Department of Urology, New York University School of Medicine, New York, New York, USA.
J Urol. 2012 Sep;188(3):786-91. doi: 10.1016/j.juro.2012.05.011. Epub 2012 Jul 19.
The effect of statins on prostate cancer recurrence has been investigated in several studies with inconsistent results. We investigated whether statins were associated with biochemical recurrence in a large cohort of men after radical prostatectomy. We also performed a meta-analysis of existing studies.
A total of 1,446 patients who underwent radical prostatectomy at New York University were followed a median of 57 months for biochemical recurrence events. Baseline demographic and clinical characteristics were compared between 437 statin users and 1,009 nonusers. Kaplan-Meier curves and Cox models were used to examine biochemical recurrence-free survival by statin use. A meta-analysis was performed with data from our cohort and 5 published studies using the random effects model.
Statin users were slightly older and more likely to have diabetes (p <0.01). They were similar to nonusers in race and body mass index. Although preoperative prostate specific antigen and tumor stage were similar between the 2 groups, the proportion of patients with pathological Gleason score 7-10 tumors was slightly higher among statin users (p = 0.03). The biochemical recurrence-free survival rate was 87.4% and 89.0% for statin users and nonusers, respectively, at the end of followup (log rank p = 0.26). Overall biochemical recurrence was not associated with statin use (HR 1.15, 95% CI 0.82-1.61). Results were similar when patients were stratified by D'Amico low and intermediate or high risk groups. Meta-analysis revealed no overall association between statins and biochemical recurrence (pooled HR 1.00, 95% CI 0.80-1.19).
Our findings are consistent with the results of the meta-analysis, which indicated that preoperative statin use does not impact the overall risk of biochemical recurrence.
他汀类药物对前列腺癌复发的影响在几项研究中进行了探讨，但结果不一致。我们研究了他汀类药物是否与根治性前列腺切除术后大量男性患者的生化复发有关。我们还对现有研究进行了荟萃分析。
共有 1446 名在纽约大学接受根治性前列腺切除术的患者接受了中位 57 个月的生化复发事件随访。比较了 437 名他汀类药物使用者和 1009 名非使用者的基线人口统计学和临床特征。使用 Kaplan-Meier 曲线和 Cox 模型比较他汀类药物使用与生化无复发生存率的关系。使用随机效应模型对来自我们队列和 5 项已发表研究的数据进行荟萃分析。
他汀类药物使用者年龄稍大，更可能患有糖尿病（p <0.01）。他们在种族和体重指数方面与非使用者相似。尽管两组患者的术前前列腺特异性抗原和肿瘤分期相似，但他汀类药物使用者中病理 Gleason 评分 7-10 肿瘤的比例略高（p = 0.03）。在随访结束时，他汀类药物使用者的生化无复发生存率分别为 87.4%和 89.0%（对数秩检验 p = 0.26）。总体生化复发与他汀类药物使用无关（HR 1.15，95%CI 0.82-1.61）。当根据 D'Amico 低、中危或高危组对患者进行分层时，结果相似。荟萃分析显示，他汀类药物与生化复发之间无总体相关性（汇总 HR 1.00，95%CI 0.80-1.19）。
我们的研究结果与荟萃分析结果一致，表明术前使用他汀类药物不会影响生化复发的总体风险。
