OBJECTIVES: To assess the impact of statin use on outcomes of patients with non-muscle-invasive bladder cancer (NMIBC).
To measure the effect of statin use on the efficacy of intravesical bacillus Calmette-Guérin (BCG) therapy.
PATIENTS AND METHODS: A retrospective analysis was performed on 1117 patients treated with transurethral resection of the bladder (TURB) for NMIBC at three institutions between 1996 and 2007. Statin use at the time of diagnosis was recorded for each patient. Univariable Cox regression models addressed the association of statin use with disease recurrence, disease progression, cancer-specific mortality and overall mortality in all patients, patients with primary NMIBC, patients not treated with BCG, and patients treated with BCG.
RESULTS: Overall, 341 patients (30.5%) used statins and 776 (69.5%) did not. Within a median (interquartile range) follow-up of 62.7 (25.0-110.7) months, 469 patients (42.0%) experienced disease recurrence, 103 (9.2%) progression, 50 (4.5%) cancer-specific mortality, and 299 (26.8%) any-cause mortality. In univariable Cox regression analyses, statin use was not associated with any of these four endpoints (P > 0.05 for all). In subgroup analyses, statin use was also not associated with prognosis in patients with primary NMIBC or patients not receiving BCG (P > 0.05 for all four endpoints). Statin use was not associated with response to BCG (P > 0.05 for all four endpoints).
CONCLUSION: Statin users did not experience different outcomes compared with non-users and statin use did not affect the efficacy of BCG immunotherapy; these data do not support modification or discontinuation of statin therapy for patients with NMIBC.
Crivelli JJ, Xylinas E, Kluth LA, da Silva RD, Chrystal J, Novara G, Karakiewicz PI, David SG, Scherr DS, Lotan Y, Shariat SF. Are you the author?
Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA.
Reference: BJU Int. 2013 Jul;112(2):E4-E12.