Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI.
Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI.
Urology. 2014 Jun;83(6):1356-61. doi: 10.1016/j.urology.2014.02.015. Epub 2014 Apr 16.
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).
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.
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.
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.
探讨接受根治性耻骨后前列腺切除术（RRP）治疗的遗传性和/或早发性前列腺癌男性患者使用他汀类药物是否与生化复发（BCR）风险降低相关。
研究对象为入组密歇根大学前列腺癌遗传学项目的遗传性和/或早发性前列腺癌男性患者。入组前列腺癌遗传学项目的男性接受调查，以确定其在 1999 年至 2009 年期间他汀类药物的使用史。通过病历获取诊断和治疗数据。BCR 定义为 RRP 治疗后前列腺特异性抗原水平单次升高至≥0.4ng/mL。他汀类药物的使用被建模为一个时间依赖性变量，使用未经调整和调整已知临床预后因素的粗 Cox 比例风险模型来检查 RRP 后的 BCR。
本研究共纳入 539 例接受 RRP 治疗的男性。其中，47.9%的男性使用了他汀类药物，115 名（21%）男性发生了复发。在未调整的模型中（风险比=1.04，95%置信区间=0.72-1.49，P 值=0.86）或在调整了临床特征的模型中（风险比=1.06，95%置信区间=0.68-1.64，P 值=0.81），他汀类药物的使用与复发风险均无相关性。此外，在比较高 Gleason 分级癌症与低 Gleason 分级癌症的男性时，也未观察到相关性。
在本研究中，RRP 后使用他汀类药物与 BCR 风险降低无关；然而，这些具有更高前列腺癌风险的男性可能是他汀类药物使用以减缓或预防 BCR 的进一步研究的亚组人群。
