他汀类药物联合治疗对非肌层浸润性膀胱癌患者的潜在益处。
The potential benefits of concomitant statins treatment in patients with non-muscle-invasive bladder cancer.
作者信息
Liu Kang, Nicoletti Rossella, Zhao Hongda, Chen Xuan, Chiu Peter Ka-Fung, Ng Chi-Fai, Pichler Renate, Mertens Laura S, Yanagisawa Takafumi, Afferi Luca, Mari Andrea, Katayama Satoshi, Rivas Juan Gomez, Campi Riccardo, Mir Maria Carmen, Rink Michael, Lotan Yair, Rouprêt Morgan, Shariat Shahrokh F, Teoh Jeremy Yuen-Chun
机构信息
S.H. Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Department of Experimental and Clinical Biomedical Science, University of Florence, Florence, Italy.
出版信息
BJU Int. 2025 Jan;135(1):88-94. doi: 10.1111/bju.16493. Epub 2024 Sep 10.
OBJECTIVE
To investigate the influence of statins on the survival outcomes of patients with non-muscle-invasive bladder cancer (NMIBC) treated with adjuvant intravesical bacille Calmette-Guérin (BCG) immunotherapy.
PATIENTS AND METHODS
A retrospective cohort of consecutive patients with NMIBC who received intravesical BCG therapy from 2001 to 2020 and statins prescription were identified. Overall survival (OS), cancer-specific survival (CSS), recurrence-free survival (RFS), and progression-free survival (PFS) were analysed between the Statins Group vs No-Statins Group using Kaplan-Meier method and multivariable Cox regression.
RESULTS
A total of 2602 patients with NMIBC who received intravesical BCG were identified. The median follow-up was 11.0 years. On Kaplan-Meier analysis, the Statins Group had significant better OS (P < 0.001), CSS (P < 0.001), and PFS (P < 0.001). Subgroup analysis indicated statins treatment started before BCG treatment had better CSS (P = 0.02) and PFS (P < 0.01). Upon multivariable Cox regression analysis, the 'statins before BCG' group was an independent protective factor for OS (hazard ratio [HR] 0.607, 95% confidence interval [CI] 0.514-0.716), and CSS (HR 0.571, 95% CI 0.376-0.868), but not RFS (HR 0.885, 95% CI 0.736-1.065), and PFS (HR 0.689, 95% CI 0.469-1.013).
CONCLUSIONS
Statins treatment appears to offer protective effects on OS and CSS for patients with NMIBC receiving adjuvant intravesical BCG.
目的
探讨他汀类药物对接受辅助膀胱内卡介苗（BCG）免疫治疗的非肌层浸润性膀胱癌（NMIBC）患者生存结局的影响。
患者与方法
确定了一组2001年至2020年接受膀胱内BCG治疗且有他汀类药物处方的连续性NMIBC患者的回顾性队列。使用Kaplan-Meier法和多变量Cox回归分析他汀类药物组与非他汀类药物组之间的总生存期（OS）、癌症特异性生存期（CSS）、无复发生存期（RFS）和无进展生存期（PFS）。
结果
共确定了2602例接受膀胱内BCG治疗的NMIBC患者。中位随访时间为11.0年。在Kaplan-Meier分析中，他汀类药物组的OS（P<0.001）、CSS（P<0.001）和PFS（P<0.001）显著更好。亚组分析表明，在BCG治疗前开始他汀类药物治疗具有更好的CSS（P=0.02）和PFS（P<0.01）。经多变量Cox回归分析，“BCG治疗前使用他汀类药物”组是OS（风险比[HR]0.607，95%置信区间[CI]0.514-0.716）和CSS（HR 0.571，95%CI 0.376-0.868）的独立保护因素，但不是RFS（HR 0.885，95%CI 0.736-1.065）和PFS（HR 0.689，95%CI 0.469-1.013）的独立保护因素。
结论
他汀类药物治疗似乎对接受辅助膀胱内BCG治疗的NMIBC患者的OS和CSS具有保护作用。
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