他汀类药物使用与前列腺癌根治术后生化复发的风险。

Statin use and risk of prostate cancer biochemical recurrence after radical prostatectomy.

机构信息

Department of Internal Medicine, Rush University Medical Center, Chicago, IL.

出版信息

Urol Oncol. 2021 Feb;39(2):130.e9-130.e15. doi: 10.1016/j.urolonc.2020.09.027. Epub 2020 Oct 31.

DOI:10.1016/j.urolonc.2020.09.027

PMID:33132024

Abstract

BACKGROUND

Multiple studies have investigated the role of statins in prostate cancer (CaP), the leading cause of cancer related death in men. Retrospective cohort studies investigating the correlation between statin use and biochemical recurrence free (BCRF) survival in men with CaP have been inconclusive.

OBJECTIVES

In the largest reported surgical cohort to date, we investigated the effect of statin therapy on BCRF and overall survival in patients with CaP who have undergone radical prostatectomy (RP).

PATIENTS AND METHODS

We performed a retrospective analysis of men (n = 3,088) participating in the NCI funded Specialized Program of Research Excellence (SPORE) in CaP at Northwestern University (NM) in Chicago, Illinois. Patients were treated with RP between 2002 and 2015. Patients in the statin users group received treatment within 2 years prior to or subsequent to RP. Wilcoxon rank-sum and Fisher's exact tests were used to compare age, race, Gleason score, clinical staging, and pathological stage between statin users and nonstatin users.

RESULTS

The analysis identified 1,222 statin users and 1,865 nonusers (mean age 71 years, 92% Caucasian). After a median follow-up time of 49.0 months, the 5-year BCRF survival rate was 93.3% (95% confidence interval [CI]: 91.9-94.8%) among statin users and 88.6% (95% CI: 87.1%-90%) among nonusers (log-rank P< 0.001). After 10 years, the progression-free survival (PFS) was 91.7% (95% CI: 90.1%-93.3%) among statin users and 86.5% (95% CI: 84.4%-88.2%) among nonusers (log-rank P< 0.001).

CONCLUSIONS

Extended follow-up data in this large surgical cohort show statin use improves BCRF but not overall survival in RP patients.

摘要

背景

多项研究已经探讨了他汀类药物在前列腺癌（CaP）中的作用，CaP 是男性癌症相关死亡的主要原因。调查他汀类药物使用与 CaP 患者生化无复发生存（BCRF）之间相关性的回顾性队列研究尚无定论。

目的

在迄今为止报告的最大手术队列中，我们调查了他汀类药物治疗对接受根治性前列腺切除术（RP）的 CaP 患者 BCRF 和总生存的影响。

患者和方法

我们对在伊利诺伊州芝加哥西北大学（NM）参与国家癌症研究所资助的前列腺癌专项研究计划卓越中心（SPORE）的 3088 名男性患者进行了回顾性分析。患者于 2002 年至 2015 年期间接受 RP 治疗。他汀类药物使用者组的患者在 RP 之前或之后的 2 年内接受治疗。Wilcoxon 秩和检验和 Fisher 确切概率法用于比较他汀类药物使用者和非使用者之间的年龄、种族、Gleason 评分、临床分期和病理分期。

结果

分析确定了 1222 名他汀类药物使用者和 1865 名非使用者（平均年龄 71 岁，92%为白种人）。中位随访时间为 49.0 个月后，他汀类药物使用者的 5 年 BCRF 生存率为 93.3%（95%CI：91.9-94.8%），而非使用者为 88.6%（95%CI：87.1%-90%）（对数秩 P<0.001）。10 年后，他汀类药物使用者的无进展生存（PFS）率为 91.7%（95%CI：90.1%-93.3%），而非使用者为 86.5%（95%CI：84.4%-88.2%）（对数秩 P<0.001）。