Department of Urology, University of Rochester Medical Center, Rochester, NY, USA.
BJU Int. 2013 Mar;111(3 Pt B):E71-7. doi: 10.1111/j.1464-410X.2012.11527.x. Epub 2012 Sep 27.
What's known on the subject? and What does the study add? Over the last few years, several observational studies examined the association of statin use with the risk of biochemical recurrence of prostate cancer after definitive local therapy. The objective of our present study was to summarise available evidence on this subject using the method of meta-analysis. Combined evidence from eight cohort studies did not definitively support the hypothesis that statins influence the risk of biochemical recurrence. However, there was considerable disagreement between individual studies in reported findings and conclusions.
To perform a systematic review and meta-analysis of clinical studies with statin use as the exposure variable and biochemical recurrence after definitive local therapy for prostate cancer as the outcome.
Relevant publications were identified through PubMed/Medline/Embase databases. Pooled estimates of the hazard ratios (HRs) were computed using the inverse-variance weighting approach. Heterogeneity was assessed using the Cochran's Q test.
We identified a total of eight eligible studies, all based on the retrospective cohort design. Five of these were based on radical prostatectomy (RP) series and three on radiotherapy (RT) series. There was evidence of heterogeneity in the entire set of eight studies (P = 0.002) as well as in the RP series (P = 0.05) and in the RT series (P = 0.01), when these were considered separately. Based on the random effects inverse-variance weighting approach, pooled estimates of the HRs for the risk of biochemical recurrence in statin users v non-users were 0.91 (95% confidence interval [CI] 0.72-1.13) for the entire set of eight studies, 1.02 (95% CI 0.80-1.29) for the RP series and 0.71 (95% CI 0.44-1.16) for the RT series.
The pooled estimates of the HRs were not significantly different from the null value in this meta-analysis; however, evidence of heterogeneity between the studies was present.
系统评价和荟萃分析使用他汀类药物作为暴露变量和前列腺癌根治性局部治疗后生化复发作为结局的临床研究。
通过 PubMed/Medline/Embase 数据库确定相关出版物。使用逆方差加权法计算合并估计的危险比（HRs）。使用 Cochran's Q 检验评估异质性。
共纳入 8 项符合条件的研究，均为回顾性队列设计。其中 5 项基于根治性前列腺切除术（RP）系列，3 项基于放疗（RT）系列。8 项研究的整个数据集存在异质性（P = 0.002），RP 系列（P = 0.05）和 RT 系列（P = 0.01）也存在异质性。基于随机效应逆方差加权法，他汀类药物使用者与非使用者生化复发风险的合并 HR 估计值分别为 0.91（95%置信区间 [CI] 0.72-1.13）、整个 8 项研究、RP 系列为 1.02（95%CI 0.80-1.29）和 RT 系列为 0.71（95%CI 0.44-1.16）。
本荟萃分析中，合并 HRs 的估计值与零值无显著差异；然而，研究之间存在异质性的证据。
