Association between statins and prostate tumor inflammatory infiltrate in men undergoing radical prostatectomy.
BACKGROUND
Cholesterol-lowering drugs known as statins have been reported to have significant anti-inflammatory properties. Given that inflammation may contribute to prostate cancer progression and that statins may reduce the risk for advanced prostate cancer, we investigated whether statin use was associated with reduced intratumoral inflammation in radical prostatectomy (RP) specimens.


METHODS
Inflammation within index tumors of 236 men undergoing RP from 1996 to 2004 was graded by a single pathologist as grade 0 (absent), 1 (mild: < or =10%), and 2 (marked: >10%). Preoperative statin use was analyzed by grouping subjects as statin users or nonusers. Type and dosage of statin was accounted for using dose equivalents with 20 mg simvastatin as reference. Logistic regression was used to determine the association between statin use and intratumoral inflammation controlling for age, race, body mass index, prostate-specific antigen, year of surgery, clinical stage, pathologic Gleason sum, surgical margin status, extracapsular extension, seminal vesicle invasion, prostate weight, time from prostate biopsy to RP, and nonsteroidal anti-inflammatory drug use.


RESULTS
Preoperative statin use was significantly associated with lower risk for any (grade > or =1) intratumoral inflammation (odds ratio, 0.31; 95% confidence interval, 0.10-0.98; P = 0.047) on multivariable analysis, with doses > or =20 mg simvastatin equivalents being more strongly associated (relative to nonuse; odds ratio, 0.22; 95% confidence interval, 0.06-0.79; P = 0.02).


CONCLUSIONS
In a cohort of men undergoing RP, statin use was associated with significantly lower risk of any inflammation within prostate tumors.


CONCLUSIONS
Given previous reports that inflammation is associated with advanced prostate cancer, and statin use is associated with decreased prostate cancer progression risk, our findings suggest that inhibition of inflammation within tumors may be a potential mechanism for purported anti-prostate cancer properties of statins.
Bañez
Lionel L
LL
Division of Urologic Surgery and Duke Prostate Center, Department of Surgery, Duke University Medical Center, Box 2626, MSRB-I Room 455B, 571 Research Drive, Durham, NC 27710, USA. lionel.banez@duke.edu
Klink
Joseph C
JC
Jayachandran
Jayakrishnan
J
Lark
Amy L
AL
Gerber
Leah
L
Hamilton
Robert J
RJ
Masko
Elizabeth M
EM
Vollmer
Robin T
RT
Freedland
Stephen J
SJ
D000368:Aged; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007249:Inflammation / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors