title: Statin use and the risk of biochemical recurrence of prostate cancer after definitive local therapy: a meta-analysis of eight cohort studies.
abstract: What's known on the subject? and What does the study add? Over the last few years, several observational studies examined the association of statin use with the risk of biochemical recurrence of prostate cancer after definitive local therapy. The objective of our present study was to summarise available evidence on this subject using the method of meta-analysis. Combined evidence from eight cohort studies did not definitively support the hypothesis that statins influence the risk of biochemical recurrence. However, there was considerable disagreement between individual studies in reported findings and conclusions.
  
  
  OBJECTIVE
  To perform a systematic review and meta-analysis of clinical studies with statin use as the exposure variable and biochemical recurrence after definitive local therapy for prostate cancer as the outcome.
  
  
  METHODS
  Relevant publications were identified through PubMed/Medline/Embase databases. Pooled estimates of the hazard ratios (HRs) were computed using the inverse-variance weighting approach. Heterogeneity was assessed using the Cochran's Q test.
  
  
  RESULTS
  We identified a total of eight eligible studies, all based on the retrospective cohort design. Five of these were based on radical prostatectomy (RP) series and three on radiotherapy (RT) series. There was evidence of heterogeneity in the entire set of eight studies (P = 0.002) as well as in the RP series (P = 0.05) and in the RT series (P = 0.01), when these were considered separately. Based on the random effects inverse-variance weighting approach, pooled estimates of the HRs for the risk of biochemical recurrence in statin users v non-users were 0.91 (95% confidence interval [CI] 0.72-1.13) for the entire set of eight studies, 1.02 (95% CI 0.80-1.29) for the RP series and 0.71 (95% CI 0.44-1.16) for the RT series.
  
  
  CONCLUSIONS
  The pooled estimates of the HRs were not significantly different from the null value in this meta-analysis; however, evidence of heterogeneity between the studies was present.
authors.affiliation: Department of Urology, University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Emil
authors.initials: E
authors.lastname: Scosyrev
authors.forename: Scott
authors.initials: S
authors.lastname: Tobis
authors.forename: Heather
authors.initials: H
authors.lastname: Donsky
authors.forename: Guan
authors.initials: G
authors.lastname: Wu
authors.forename: Jean
authors.initials: J
authors.lastname: Joseph
authors.forename: Hani
authors.initials: H
authors.lastname: Rashid
authors.forename: Edward
authors.initials: E
authors.lastname: Messing
mesh_terms: D015331:Cohort Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000453:epidemiology* / Q000209:etiology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000453:epidemiology* / Q000209:etiology*; D012306:Risk
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D017430:Prostate-Specific Antigen