Influencia del empleo de estatinas en el cáncer de próstata clínicamente localizado tratado con prostatectomía radical

Mora, Enrique Rijo; Garín, J.A. Lorente; Gali, O. Bielsa; Comalat, Albert Francés; Fumadó, Lluís; Toro, Octavio Arango

doi:10.1016/s0210-4806(09)74159-2

Cited by 3 publications

(5 citation statements)

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“…Despite the biological plausibility, few studies have investigated the association of statins with pathological characteristics and risk of recurrence. For the pathological characteristics, our results differ from those from 1 small study, 12 but are consistent with those from a later, larger study. 13 For recurrence, our results are consistent with 4 published studies, 14,15,17,18 but not with the other report.…”

Section: Discussionsupporting

confidence: 68%

“…14-19 A retrospective study in 250 patients reported that statins were associated with more favorable pathological characteristics, but this association did not persist after adjustment. 12 A larger study in 1,351 patients found that statin users had more favorable pathological characteristics than nonusers. 13 Studies addressing statin use and recurrence have reported conflicting results.…”

mentioning

confidence: 98%

“…2,4-11 Few studies have examined the influence of statins on pathological characteristics of prostate cancers 12,13 and recurrence after treatment. 14-19 A retrospective study in 250 patients reported that statins were associated with more favorable pathological characteristics, but this association did not persist after adjustment.…”

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confidence: 99%

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Association of Statin Use With Pathological Tumor Characteristics and Prostate Cancer Recurrence After Surgery

et al. 2011

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Purpose-Prospective studies suggest that statins protect against advanced stage and possibly high grade prostate cancer. However, few studies have investigated the influence of stains on outcomes in men with prostate cancer. Thus, we evaluated the association of statin use with pathological tumor characteristics and prostate cancer recurrence after prostatectomy in a retrospective cohort.Materials and Methods-A total of 2,399 patients of 1 surgeon at Johns Hopkins Hospital who underwent radical prostatectomy in 1993 to 2006 and had not previously received hormone or radiation therapy were followed for recurrence. The surgeon routinely asked during the preoperative consultation what medications the men were using. Additional information on statin use was obtained from a mailed survey. We estimated the association of statin use with nonorgan confined disease (pT3a/b or N1) and high grade disease (Gleason sum [4 + 3] or greater) using logistic regression (OR), and recurrence using Cox proportional hazards regression (HR).Results-The 16.1% of men who used a statin at prostatectomy were statistically significantly less likely to have nonorgan confined disease than nonusers (OR 0.66, 95% CI 0.50-0.85). Statin use was inversely associated with high grade disease only in men with preoperative PSA 10 ng/ml or greater (OR 0.35,. The HR of recurrence among men who used a statin for 1 year or greater compared to nonusers was 0.77 (95% CI 0.41-1.42). We excluded 2.8% of the men from analysis because of missing information on medication use. Of the men 1.2% were excluded since they received hormone or radiation therapy before prostatectomy. After these exclusions 2,399 men remained in the study cohort. Median followup was 7 years and the proportion of total possible followup observed was 76%. This study was approved by the institutional review boards at the Johns Hopkins School of Medicine and the Johns Hopkins Bloomberg School of Public Health. Conclusions-Our AssessmentStatin use-Medical records for the preoperative consultation were reviewed and information on all medications used, including statins, aspirin, nonaspirin nonsteroidal antiinflammatory drugs, ACE inhibitors, α-adrenergic blockers, and diabetes medications, was abstracted while blinded to the outcome. Drug dose was not available.Information on the timing and duration of statin use was obtained from a survey on lifestyle and medical factors mailed to the 2,209 men who were alive and residing in the United States as of November 2007. Of the 2,399 men 1.8% died before the surveys were mailed. The men were asked whether they had used a statin before or after prostatectomy and, if so, for how long (less than 1, 1 to 4, 5 to 9, or 10 years or greater). Of the 2,209 eligible men 1,583 (72%) responded by August 2009 and were included in analysis. When statin use reported on the survey conflicted with information from the preoperative consultation (8% of cases), we used the information from the preoperative consultation. Outcome-Prostatectomy specimens were ev...

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Section: Discussionsupporting

confidence: 68%

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confidence: 98%

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Association of Statin Use With Pathological Tumor Characteristics and Prostate Cancer Recurrence After Surgery

et al. 2011

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“…Statin use has been associated with better progression-free survival [16] and lower recurrence risk [15] among men with prostate cancer treated with curative intent on univariate but not multivariate analysis [16]. Gutt et al [13] found statin use to be associated with better relapse-free survival and freedom from androgen deprivation therapy but not overall or cause-specific survival.…”

Section: Discussionmentioning

confidence: 99%

“…In men with a preexisting diagnosis of prostate cancer, a prospective study did not show an association between this medication and prostate cancer death [11]; this is in contrast to a more recent study which found a lower risk of prostate cancer death in users of acetylsalicylic acid [12]. Some reports have suggested that statin use was associated with improved biochemical control [13, 14] but its effect in survival is less clear [13, 15, 16]. …”

Section: Introductionmentioning

confidence: 99%

Does Statin or ASA Affect Survival When Prostate Cancer Is Treated with External Beam Radiation Therapy?

et al. 2014

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Background. Prior studies evaluating the effect of statins or acetylsalicylic acid (ASA) on the survival of men receiving prostate cancer were treatment have reported conflicting results, and have not adjusted for comorbidity. Our aim is to investigate the influence of statins and ASA on prostate cancer survival, when comorbidity is adjusted for, in men treated with external beam radiation therapy (EBRT) for prostate cancer. Methods. A cohort of 3851 patients with prostate cancer treated with curative EBRT ± androgen deprivation therapy (ADT) between 2000 and 2007. Stage, treatment, medication use, and Charlson comorbidity index (CCI) scores were analyzed. Results. Median followup was 8.4 years. Mean age was 70.3 years. Neoadjuvant ADT was used in 67%. Statins were used in 23%, ASA in 24%, and both in 11%. Comorbidity scores were 0 in 65%, 1 in 25%, and ≥2 in 10% of patients. Statin and ASA use were associated with increased age and comorbidity. Although statin and ASA use were significantly associated with improved prostate cancer specific survival (PCSS) on univariate analysis, neither were on multivariate analysis. Conclusion. Neither statin nor ASA use impacted PCSS on multivariate competing risks analysis. Survival was impacted by increased comorbidity as well as statin and ASA use.

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Preoperative Statin Therapy is not Associated with Biochemical Recurrence After Radical Prostatectomy: Our Experience and Meta-Analysis

et al. 2012

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Influencia del empleo de estatinas en el cáncer de próstata clínicamente localizado tratado con prostatectomía radical

Cited by 3 publications

References 10 publications

Association of Statin Use With Pathological Tumor Characteristics and Prostate Cancer Recurrence After Surgery

Association of Statin Use With Pathological Tumor Characteristics and Prostate Cancer Recurrence After Surgery

Does Statin or ASA Affect Survival When Prostate Cancer Is Treated with External Beam Radiation Therapy?

Preoperative Statin Therapy is not Associated with Biochemical Recurrence After Radical Prostatectomy: Our Experience and Meta-Analysis

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