Berquist Sean W, Lee Hak J, Hamilton Zachary, Bagrodia Aditya, Hassan Abd-Elrahman, Beksaç Alp T, Dufour Catherine A, Wang Song, Mehrazin Reza, Patterson Anthony, Derweesh Ithaar H
Department of Urology, UC San Diego Health System, La Jolla, CA, USA.
Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Minerva Urol Nefrol. 2017 Oct;69(5):501-508. doi: 10.23736/S0393-2249.17.02788-6. Epub 2017 Mar 30.
We evaluated the role of statins in patients who underwent surgery for renal cell carcinoma (RCC) and who had dyslipidemia, as use of statins has been suggested to improve outcomes in RCC.
Two-center retrospective study of patients with dyslipidemia who underwent surgery for RCC from 7/1995 to 6/2005. Patients were managed by statins or ezetimibe, fibrate agents, or cholestyramine. Analysis was conducted between patients who received statin therapy versus those that did not. Primary outcome was progression-free survival (PFS). Secondary outcomes were cancer-specific (CSS) and overall survival (OS). Multivariable analysis was performed to identify risk factors associated with disease progression.
In this study 283 patients were analyzed (180 statin, 103 non-statin, median follow-up 68 months). There were no significant demographic differences. Median duration of antidyslipidemia therapy was similar (statin 31 months vs. non-statin 28 months, P=0.413). Tumor size (statin 5.4 cm vs. non-statin 5.6 cm, P=0.569), stage distribution (P=0.591), histology (P=0.801), and grade (P=0.807) were similar. Kaplan-Meier analysis demonstrated higher 5-yr PFS (91% vs. 70%, P<0.001), CSS (88% vs. 69%, P<0.001), and OS (71% vs. 67%, P=0.025) in statin vs. non-statin patients. Multivariable analysis for factors associated with disease progression found absence of statin therapy (OR 2.41, P<0.001), higher stage (OR 2.01-3.86 P<0.001), and higher grade tumors (OR 2.07, P=0.006) to be predictive.
In RCC patients with dyslipidemia, statin use was associated with improved survival outcomes, and was an independent predictor of PFS. Further investigations are requisite to determine utility of statins in RCC patients.
我们评估了他汀类药物在接受肾细胞癌（RCC）手术且患有血脂异常的患者中的作用，因为有人提出使用他汀类药物可改善RCC的预后。
对1995年7月至2005年6月期间接受RCC手术的血脂异常患者进行两中心回顾性研究。患者接受他汀类药物、依泽替米贝、贝特类药物或考来烯胺治疗。对接受他汀类药物治疗的患者与未接受他汀类药物治疗的患者进行分析。主要结局是无进展生存期（PFS）。次要结局是癌症特异性生存期（CSS）和总生存期（OS）。进行多变量分析以确定与疾病进展相关的危险因素。
本研究共分析了283例患者（180例接受他汀类药物治疗，103例未接受他汀类药物治疗，中位随访68个月）。人口统计学特征无显著差异。抗血脂异常治疗的中位持续时间相似（他汀类药物组为31个月，非他汀类药物组为28个月，P = 0.413）。肿瘤大小（他汀类药物组为5.4 cm，非他汀类药物组为5.6 cm，P = 0.569）、分期分布（P = 0.591）、组织学（P = 0.801）和分级（P = 0.807）相似。Kaplan-Meier分析显示，他汀类药物治疗组的5年PFS（91%对70%，P<0.001）、CSS（88%对69%，P<0.001）和OS（71%对67%，P = 0.025）均高于非他汀类药物治疗组。对与疾病进展相关因素的多变量分析发现，未接受他汀类药物治疗（OR 2.41，P<0.001）、更高分期（OR 2.01 - 3.86，P<0.001）和更高分级肿瘤（OR 2.07，P = 0.006）具有预测性。
在患有血脂异常的RCC患者中，使用他汀类药物与改善生存结局相关，并且是PFS的独立预测因素。需要进一步研究以确定他汀类药物在RCC患者中的效用。
