Impact of statin use on overall and time to biochemical failure following radical prostatectomy or radiation therapy

Huynh, Linda; Keit, Emily; Schuller, Aviva Atri; Carrillo, Raymond Ceja; Huang, Erica; Ahlering, Thomas E.; Boyle, Shawna; Enke, Charles Arthur; Baine, Michael J.

doi:10.1007/s00345-021-03600-0

Cited by 3 publications

(5 citation statements)

References 31 publications

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“…Although several studies found no effect of statin use on biochemical progression after radical prostatectomy, results after radiation therapy are mixed. Our results are consistent with several studies reporting no BCR benefit from the combination of statin with EBRT or brachytherapy [ 17 , 18 , 19 , 20 , 21 ]. However, in contrast to surgical series, some radiation studies did find an improvement in BCR-free survival in patients treated with statins.…”

Section: Discussionsupporting

confidence: 93%

Impact of Statin Use on Localized Prostate Cancer Outcomes after Radiation Therapy: Long-Term Follow-Up

Kaulanjan

Lavigne

Saad

et al. 2022

Cancers

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The impact of statin use on localized prostate cancer (PCa) remains controversial, especially for patients treated with radiation therapy. We assessed the impact of statin use on biochemical recurrence (BCR) in patients treated for PCa with different modalities of radiation therapy. We evaluated 3555 patients undergoing radiation therapy between January 2001 and January 2022. The impact of statin use on BCR was analyzed for three treatment groups: external beam radiotherapy (EBRT), low-dose-rate seed brachytherapy (LDR), and EBRT plus high-dose-rate brachytherapy (EBRT + HDR). Median follow-up was 52 months among 1208 patients treated with EBRT, 1679 patients treated with LDR, and 599 patients treated with EBRT + HDR. A total of 1544 (43%) patients were taking a statin at the time of treatment, and 497 (14%) patients were in the D’Amico high-risk group. Only intermediate-risk patients treated with LDR fared better with statin use in univariate analysis (p = 0.025). This association was not significant in multivariate analysis (HR 0.44, 95% CI 0.18–1.10, p = 0.06). Statin use was not associated with a reduced risk of BCR in patients treated with radiation therapy. In the era of precision medicine, further investigation is needed to assess the benefit of statins in well-defined patients.

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Section: Discussionsupporting

confidence: 93%

Impact of Statin Use on Localized Prostate Cancer Outcomes after Radiation Therapy: Long-Term Follow-Up

Kaulanjan

Lavigne

Saad

et al. 2022

Cancers

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“…Thirty-one studies reported the Gleason score, and the percentage of patients with Gleason score ≥7 in the majority of studies was between 50% and 70%. However, all the patients had a Gleason score <7 in two studies ( 37 , 39 ). There were no significant differences in Gleason score and statin use.…”

Section: Resultsmentioning

confidence: 96%

“…All the studies were observational cohort studies published between 2006 and 2021. Twenty-four studies were conducted in the United States ( 35 , 37 , 40 , 43 – 48 , 51 – 54 , 56 – 59 , 61 – 67 ), two in South Korea ( 42 , 60 ), one in Portugal ( 38 ), one in Greece ( 50 ), one in France ( 55 ), two in Finland ( 36 , 41 ), and one in Canada ( 39 ), and one study collected data from six centers located in the North America and Europe ( 49 ). The study cohort size ranged from 247 ( 43 ) to 6,842 ( 49 ) among the included studies.…”

Section: Resultsmentioning

confidence: 99%

“…Two studies chose ADT as their primary treatment, and one study brought into patients treated with RP or RT or ADT. In some studies, patients accepting adjuvant treatment before RP or RT were excluded ( 37 , 45 , 52 , 53 , 57 , 60 , 65 ). The definition of the BCR in most studies were the same: a posttreatment PSA value of 0.2 ng/ml or greater in men who underwent RP; nadir PSA level +2 ng/ml (Phoenix criteria), for men treated with RT; any PSA increase in men treated with primary ADT; and no evidence of clinical and/or radiographically detected disease.…”

Section: Resultsmentioning

confidence: 99%

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Statin Use and the Risk of Prostate Cancer Biochemical Recurrence Following Definitive Therapy: A Systematic Review and Meta-Analysis of Cohort Studies

et al. 2022

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BackgroundNumerous studies have reported the role of statins on biochemical recurrence (BCR) among patients with prostate cancer (PCa) after definite treatment. However, the conclusions of these studies are contradictory. We aimed to determine the effect of statins on BCR of PCa using a systematic review and meta-analysis.MethodsWe searched PubMed (Medline) and other databases for cohort studies evaluating the effect of statins on the BCR of patients with PCa between January 1, 2000, and December 31, 2021. The random effects (RE) model and quality effects (QE) model were used to calculate the pooled hazard ratio (pHR) and pooled risk ratio (pRR) and their 95% confidence interval (95% CI).ResultsA total of 33 cohort studies were finally selected and included in this systematic review and meta-analysis. Statin use was significantly associated with a 14% reduction in the HR of BCR (pHR: 0.86, 95% CI: 0.78 to 0.95, I2 = 64%, random effects model, 31 studies) and a 26% reduction in the RR of BCR (pRR: 0.74, 95% CI: 0.57 to 0.94, 24,591 patients, I2 = 88%, random effects model, 15 studies) among patients with PCa. The subgroup analyses showed that statins could result in 22% reduction in the HR of BCR (pHR: 0.78, 95% CI: 0.61 to 0.98, I2 = 57%, random effects model) among patients accepting radiotherapy (RT).ConclusionsOur study suggests that statins have a unique role in the reduction of BCR in patients with PCa after definite treatment, especially RT. In the future, more clinical trials and in vitro and animal experiments are needed to further verify the effects of statins in PCa and the potential mechanisms.

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“…Otherwise, statin usage was associated with 22% decrease in metastasis possibility (pHR, 0.78; 95% CI, 0.68–0.87; p=0.001; 6 studies; I 2 =0%) and a 24% decrease in the risk of both cancer-specific death (pHR, 0.76; 95% CI, 0.64–0.89; p=0.0007; 5 studies; I 2 =40%) and overall death (pHR, 0.76; 95% CI, 0.63–0.91; p=0.004; 6 studies; I 2 =71%). Huynh et al [ 48 ] evaluated 1,581 patients undergoing RP or RT and the effect of statin usage on overall BF and the time to BF after initial treatment for localized PCa. When classified by statin usage, BF overall and within first, third, and fifth year did not differ significantly.…”

Section: Effect Of Statins On Prostate Cancermentioning

confidence: 99%

Evidence on Statins, Omega-3, and Prostate Cancer: A Narrative Review

Kim

2022

World J Mens Health

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Dietary intake selections might play a crucial role in prostate cancer (PCa) occurrence and progression. Several studies have investigated whether statin use could reduce PCa risk but with conflicting results. Nevertheless, a significantly decreased incidence of advanced PCa has been consistently noted. Statins may also reduce the risk of biochemical recurrence (BCR) in men with PCa after receiving active treatment. However, the influence of statin usage on BCR and PCa progression in men with high prostate-specific antigen levels has been found to be insignificant. In contrast, the combined use of a statin and metformin was significantly related to the survival status of PCa patients. However, some studies have revealed that the intake of long-chain omega-3 fatty acid (ω-3) from fish or fish oil supplements may elevate PCa risk. Several meta-analyses on ω-3 consumption and PCa have shown controversial results for the relationship between PCa and ω-3 consumption. However, studies with positive results for various genotypes, fatty acid intake or levels, and PCA risk are emerging. This review highlights the association among statins, ω-3, and PCa. The findings summarized here may be helpful for clinicians counseling patients related to PCa.

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Impact of statin use on overall and time to biochemical failure following radical prostatectomy or radiation therapy

Cited by 3 publications

References 31 publications

Impact of Statin Use on Localized Prostate Cancer Outcomes after Radiation Therapy: Long-Term Follow-Up

Impact of Statin Use on Localized Prostate Cancer Outcomes after Radiation Therapy: Long-Term Follow-Up

Statin Use and the Risk of Prostate Cancer Biochemical Recurrence Following Definitive Therapy: A Systematic Review and Meta-Analysis of Cohort Studies

Evidence on Statins, Omega-3, and Prostate Cancer: A Narrative Review

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