Chen Tzu Shuang, Liu Hui Ying, Chang Yin Lun, Chuang Yao Chi, Chen Yen Ta, Su Yu Li, Huang Chun Chieh, Wu Yen Ting, Wang Hung Jen, Luo Hao Lun
Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Department of Hematology and Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
World J Mens Health. 2024 Jul;42(3):630-637. doi: 10.5534/wjmh.230155. Epub 2024 Jan 2.
Numerous studies have produced conflicting findings regarding the efficacy of statins in prostate cancer treatment. Our objective was to examine the correlation between statin usage and clinical outcomes in Taiwanese men with metastatic prostate cancer.
We identified patients diagnosed with metastatic prostate cancer from the Chang Gung Research Database spanning the years 2007 to 2020. To minimize confounding bias, we employed the inverse probability of treatment weighting (IPTW) method. Clinical outcomes were assessed using IPTW-adjusted Kaplan-Meier curves. Multivariate Cox proportional hazard regression analysis was utilized to evaluate the association between mortality and clinical factors.
The study cohort comprised 1,716 statin users and 276 non-users. Patients who used statins exhibited a longer median overall survival (85.4 months compared to 58.2 months; p=0.001) and cancer-specific survival (112.6 months compared to 75.7 months; p<0.001) compared to non-users. The median time to the development of castration-resistant status was similar between statin users and non-users (p=0.069). Multivariable Cox proportional hazards regression analysis, after IPTW adjustment, demonstrated that statin use was associated with improved overall survival.
Our study indicates that the use of statins following a metastatic prostate cancer diagnosis enhances survival outcomes. However, statins did not appear to delay the onset of castration-resistant status. Further large-scale and long-term studies are warranted to investigate the biological effects of statins in men with prostate cancer.
关于他汀类药物在前列腺癌治疗中的疗效，众多研究得出了相互矛盾的结果。我们的目的是研究台湾转移性前列腺癌男性患者中他汀类药物使用与临床结局之间的相关性。
我们从长庚研究数据库中识别出2007年至2020年期间被诊断为转移性前列腺癌的患者。为尽量减少混杂偏倚，我们采用了治疗权重逆概率（IPTW）方法。使用IPTW调整后的Kaplan-Meier曲线评估临床结局。采用多变量Cox比例风险回归分析来评估死亡率与临床因素之间的关联。
研究队列包括1716名他汀类药物使用者和276名非使用者。与非使用者相比，使用他汀类药物的患者总体生存中位数更长（分别为85.4个月和58.2个月；p = 0.001），癌症特异性生存中位数也更长（分别为112.6个月和75.7个月；p < 0.001）。他汀类药物使用者和非使用者之间去势抵抗状态出现的中位时间相似（p = 0.069）。在IPTW调整后的多变量Cox比例风险回归分析表明，使用他汀类药物与改善总体生存相关。
我们的研究表明，转移性前列腺癌诊断后使用他汀类药物可提高生存结局。然而，他汀类药物似乎并未延迟去势抵抗状态的出现。有必要进行进一步的大规模长期研究，以调查他汀类药物对前列腺癌男性患者的生物学影响。
