Statin use not associated with improved outcomes in patients treated with brachytherapy for prostate cancer

Cuaron, John; Pei, Xin; Cohen, Gilad; Cox, Brett; Yamada, Yoshiya; Zeléfsky, Michael J.

doi:10.1016/j.brachy.2014.05.019

Cited by 12 publications

(9 citation statements)

References 22 publications

(18 reference statements)

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“…After removing 156 studies, a total of 95 studies met the inclusion criteria and were included in the final analysis (Fig. and Supporting Information Table S2) …”

Section: Resultsmentioning

confidence: 99%

Effects of statins on cancer mortality and progression: A systematic review and meta‐analysis of 95 cohorts including 1,111,407 individuals

Mei

Liang

et al. 2017

Intl Journal of Cancer

115

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Statins have been implicated in the regulation of cell proliferation, apoptosis and tumor progression in cancer patients and statin use at the time of cancer diagnosis has been reported to be associated with reduced cancer risk and improved survival, irrespective of concomitant anti-cancer therapy. A systematic literature search of relevant databases through May 2015 was conducted to identify studies assessing the prognostic impact of statin use on prognostic outcomes in cancer patients. Literature search identified 95 cohort studies that met the inclusion criteria. A meta-analysis of 55 articles showed that statin use was significantly associated with decreased risk of all-cause mortality (HR 0.70, 95% Cl 0.66 to 0.74) compared with nonusers. The observed pooled estimates were retained for cancer-specific mortality (HR 0.60, 95% Cl 0.47 to 0.77), progression-free survival (HR 0.67, 95% Cl 0.56 to 0.81), recurrence-free survial (HR 0.74, 95% Cl 0.65 to 0.83) and disease-free survival (HR 0.53, 95% Cl 0.40 to 0.72). These associations almost remained consistent across those outcomes when stratified by publication type, tumour location, study design, sample size, initiation of statins, disease stage, research country, follow-up duration or research hospital involved. Subgroup analyses according to initiation of statins showed postdiagnosis statin users (HR 0.65, 95% Cl 0.54 to 0.79) gained significantly more recurrence-free survival benefit than prediagnosis statin users (HR 0.86, 95% Cl 0.77 to 0.96) (p for interaction = 0.018). Statin therapy has potential survival benefit for patients with malignancy. Further large-scale prospective studies emphasising survival outcomes of individual cancer type are strongly encouraged.

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“…After removing 156 studies, a total of 95 studies met the inclusion criteria and were included in the final analysis (Fig. and Supporting Information Table S2) …”

Section: Resultsmentioning

confidence: 99%

Effects of statins on cancer mortality and progression: A systematic review and meta‐analysis of 95 cohorts including 1,111,407 individuals

Mei

Liang

et al. 2017

Intl Journal of Cancer

115

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“…A total of 3229 publications were identified during the initial search (see Additional file 1. ), and after employing exclusion criteria, a total of 22 studies were included for PCa recurrence analysis 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 ( Table 1 ), 8 trials were available for PCa-specific mortality 22 30 31 32 33 34 35 36 ( Table 2 ), and 13 for BCR-free survival analysis 8 9 11 14 17 20 25 29 36 37 38 39 40 ( Table 3 ). Among 22 studies included in meta-analysis for PCa recurrence, 14 included a population primarily treated with radical prostatectomy (RP).…”

Section: Resultsmentioning

confidence: 99%

“…One of 13 trials evaluating the BCR-free survival suggested that statins users had a lower 5-year BCR-free survival rate compared with non-users 17 , while some reveled reversely 9 25 37 or showed there was no difference between two groups 20 . Meanwhile, the BCR-free survival rate at 8 or 9-year were still inconsistent 8 14 40 . However, the BCR-free survival rate at 10 year among statins users was much higher compared with non-users 36 38 .…”

Section: Discussionmentioning

confidence: 99%

The effect of statins on prostate cancer recurrence and mortality after definitive therapy: a systematic review and meta-analysis

Tan

Wei

Yang

et al. 2016

Sci Rep

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In this work, we aim to further analyze the association of statins use with biochemical recurrence (BCR) of prostate cancer (PCa) and PCa-specific mortality after definitive therapy. A systematic literature search of PubMed, MEDLINE, and EMBASE through Jul 2015 was conducted. Pooled Hazard ratio (HR) estimates with corresponding 95% confidence intervals (CIs) were calculated using random-effects model. STATA version 10 (Stata corporation, college station, TX) was employed to conduct all statistical analyses. A total of 22 and 8 studies contributed to the biochemical recurrence analysis and PCa-specific mortality, respectively. 13 trials were included for BCR-free survival analysis. The combined result showed statins users had lowered 12% BCR risk of PCa compared with non-users (HR = 0.88, 95%CI: 0.765–0.998) (p < 0.05). The association was null among the men who underwent radical prostatectomy as primary therapy (HR = 0.96, 95%CI: 0.83–1.09), while the improved outcomes had be seen among patients who received radiation therapy (HR = 0.67, 95%CI: 0.48–0.86). After excluding the patients undergoing ADT, participants did not benefit from statins use (HR = 0.94, 95%CI: 0.77–1.11). Meanwhile, long-term statins using did not alter recurrence risk. A lower risk of prostate cancer-specific mortality was observed among statins users (HR = 0.68, 95%CI: 0.56–0.80). There was a plausible trend towards increasing the BCR-free survival rate among statins users.

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“… 25 , 28 , 57 However, some studies do not support this synergism. 21 , 22 Our analysis shows significant effect of statin use in prostate cancer patients underwent radiotherapy but not in patients with radical prostatectomy.…”

Section: Discussionmentioning

confidence: 80%

The Prognostic Effect of Statin Use on Urologic Cancers

et al. 2015

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Recent studies suggest that statin may benefit cancer prognosis, especially through its radiosensitization effect. But controversy exists in other studies. Hence, we performed a meta-analysis of results from 35 studies to evaluate the effect of statin use on urologic cancers.We conducted computerized search from PubMed, Embase, and ISI Web of Knowledge through May 2015, screened the retrieved references, and collected and evaluated relevant information. We extracted and synthesized corresponding hazard ratios (HR) and confidence interval (CI) by using Review Manager 5.3 and STATA 13. This review was registered at PROSPERO with registration No. CRD42015020171.We selected total 35 retrospective studies and conducted a meta-analysis of results from these studies. The pooled results suggested no benefit of statin use to bladder cancer and renal cell carcinoma, except overall survival [HR = 0.81, 95% CI: 0.69–0.96]. However, significant improvement of prostate cancer prognosis including overall survival [HR = 0.82, 95% CI: 0.70–0.97] and cancer-specific survival [HR = 0.70, 95% CI: 0.59–0.83] was indicated, but not including tumor progression [HR = 0.84, 95% CI: 0.62–1.14]. Statin use improved biochemical recurrence of prostate cancer in radiotherapy patients [HR = 0.68, 95% CI: 0.54–0.85] but not in radical prostatectomy patients [HR = 0.97, 95% CI: 0.82–1.15].Current evidence suggests no benefit of statin use to bladder cancer and renal cell carcinoma, except in overall survival. While statin use benefited prostate cancer patients in overall survival, cancer-specific survival but not in tumor progression; it also improved biochemical recurrence in radiotherapy patients but not in radical patients. To verify these results, randomized controlled trials are necessary.

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Statin use not associated with improved outcomes in patients treated with brachytherapy for prostate cancer

Cited by 12 publications

References 22 publications

Effects of statins on cancer mortality and progression: A systematic review and meta‐analysis of 95 cohorts including 1,111,407 individuals

Effects of statins on cancer mortality and progression: A systematic review and meta‐analysis of 95 cohorts including 1,111,407 individuals

The effect of statins on prostate cancer recurrence and mortality after definitive therapy: a systematic review and meta-analysis

The Prognostic Effect of Statin Use on Urologic Cancers

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