Before launching large clinical trials to confirm the effects of statins in improving outcomes among men with prostate cancer (PC), the most appropriate target patient population and the type of statins need to be clearly identified.
A retrospective cohort study was conducted using the Taiwan Cancer Registry of 2008-2014. This study included 5749 men with locally advanced and metastatic PC who received only androgen deprivation therapy (ADT) in the first year after their cancer diagnosis. Statin users were defined as anyone who was prescribed statins for >28 days. An inverse probability of treatment-weighted Cox model was used to estimate the effects of statin use on all-cause mortality and PC-specific mortality (PCSM) while treating the statin status as a time-dependent variable.
Overall, 2259 patients died, and 1495 of them died of PC during a median follow-up of 3.6 years from 1 year after their diagnosis. Statin use was associated with significant reductions in all-cause mortality (hazard ratio [HR] = 0.78, 95% confidence interval [CI]: 0.70-0.86) and PCSM (HR = 0.76, 95% CI: 0.68-0.86) for metastatic disease and all-cause mortality (HR = 0.66, 95% CI: 0.54-0.81) for locally advanced disease. Patients who received atorvastatin, pravastatin, rosuvastatin or pitavastatin showed a stronger reduction in mortality than those who received other statins. Benefits of statins were consistently observed in men who received post-diagnostic statins, even in those with high comorbidities or an old age.
Our results suggest that only atorvastatin, pravastatin and rosuvastatin were associated with improved survival in advanced PC patients receiving ADT.
European journal of cancer (Oxford, England : 1990). 2019 Feb 28 [Epub ahead of print]
Szu-Yuan Wu, Su-Chen Fang, Hung-Jen Shih, Yu-Chin Wen, Yu-Hsuan Joni Shao
Department of Radiation Oncology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Institute of Clinical Science, Zhongshan Hospital, Fudan University, Shanghai, China., College of Nursing, Taipei Medical University, Taipei, Taiwan., Department of Urology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan., Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan; Department of Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA; Clinical Big Data Research Center, Taipei Medical University Hospital, Taipei, Taiwan. Electronic address: .