Statin medication use and the risk of biochemical recurrence after radical prostatectomy: results from the Shared Equal Access Regional Cancer Hospital (SEARCH) Database.
BACKGROUND
Although controversial, evidence suggests statins may reduce the risk of advanced prostate cancer (PC), and recently statin use was associated with prostate-specific antigen (PSA) reductions among men without PC. The authors sought to examine the association between statin use and PSA recurrence after radical prostatectomy (RP).


METHODS
The authors examined 1319 men treated with RP from the Shared Equal Access Regional Cancer Hospital (SEARCH) Database. Time to PSA recurrence was compared between users and nonusers of statin at surgery using Cox proportional hazards models adjusted for multiple clinical and pathological features.


RESULTS
In total, 236 (18%) men were taking statins at RP. Median follow-up was 24 months for statin users and 38 for nonusers. Statin users were older (P<.001) and underwent RP more recently (P<.001). Statin users were diagnosed at lower clinical stages (P=.009) and with lower PSA levels (P=.04). However, statin users tended to have higher biopsy Gleason scores (P=.002). After adjusting for multiple clinical and pathological factors, statin use was associated with a 30% lower risk of PSA recurrence (hazard ratio "HR", 0.70; 95% confidence interval "CI", 0.50-0.97; P=.03), which was dose dependent (relative to no statin use; dose equivalent<simvastatin 20 mg: HR, 1.08; 95% CI, 0.66-1.73; P=.78; dose equivalent=simvastatin 20 mg: HR, 0.57; 95% CI, 0.32-1.00; P=.05; dose equivalent>simvastatin 20 mg: HR, 0.50; 95% CI, 0.27-0.93; P=.03).


CONCLUSIONS
In this cohort of men undergoing RP, statin use was associated with a dose-dependent reduction in the risk of biochemical recurrence. If confirmed in other studies, these findings suggest statins may slow PC progression after RP.
Hamilton
Robert J
RJ
Division of Urologic Surgery, Department of Surgery, Duke University School of Medicine, Durham, North Carolina 27710, USA.
Banez
Lionel L
LL
Aronson
William J
WJ
Terris
Martha K
MK
Platz
Elizabeth A
EA
Kane
Christopher J
CJ
Presti
Joseph C
JC
Amling
Christopher L
CL
Freedland
Stephen J
SJ
D000924:Anticholesteremic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000096:biosynthesis*; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D012008:Recurrence; D012306:Risk; D019821:Simvastatin / Q000008:administration & dosage
D000924:Anticholesteremic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D019821:Simvastatin; D017430:Prostate-Specific Antigen