title: Statin use after radical prostatectomy reduces biochemical recurrence in men with prostate cancer.
abstract: BACKGROUND
  The impact of statin use on biochemical recurrence (BCR) of prostate cancer after radical prostatectomy (RP) is controversial.
  
  
  METHODS
  In 2,137 consecutive RP patients between 1998 and 2011 at Asan Medical Center, we aimed to assess the presence and impact of statin use according to types (hydrophilic vs. hydrophobic), dose equivalents (DEs), and postoperative duration of usage (<18, 18-36, >36 months). Between non-users and preoperative or postoperative users, clinicopathological characteristics, and impact of statin use on BCR were analyzed using Cox proportional hazards model. Mean (range) follow-up was 39.4 (8-183) months.
  
  
  RESULTS
  Compared to non-users, preoperative users had lower PSA (5.8 vs. 7 ng/ml), but the rates of organ confined disease, pathologic Gleason score (GS) or positive surgical margin (PSM) were not different. After adjusting for pathologic stage, postoperative statin use was associated with a higher BCR-free survival. In multivariate analysis, ≤36 months' statin use independently decreased the risk of BCR along with PSA, pathologic GS, pathologic stage, and PSM. Risk reduction was observed especially in patients with pathologic GS ≥ 7 (HR 0.27, 95% CI 0.13-0.59, P = 0.001), NSM disease (HR 0.18, 95% CI 0.05-0.63, P = 0.007), or PSA ≥ 10.0 ng/ml (HR 0.30, 95% CI 0.11-0.81, P = 0.018). Increasing duration of use nullified the effect. Preoperative statin use did not demonstrate significant risk reduction for BCR in any of the stratified multivariate models.
  
  
  CONCLUSIONS
  In Korean men undergoing RP, preoperative statin use was not associated with different pathologic outcome. However, postoperative statin use until 36 months decreased the risk of BCR independently especially in patients with high-risk disease.
authors.affiliation: Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Cheryn
authors.initials: C
authors.lastname: Song
authors.forename: Sejun
authors.initials: S
authors.lastname: Park
authors.forename: Jinsung
authors.initials: J
authors.lastname: Park
authors.forename: Myungsun
authors.initials: M
authors.lastname: Shim
authors.forename: Aram
authors.initials: A
authors.lastname: Kim
authors.forename: In Gab
authors.initials: IG
authors.lastname: Jeong
authors.forename: Jun Hyuk
authors.initials: JH
authors.lastname: Hong
authors.forename: Choung-Soo
authors.initials: CS
authors.lastname: Kim
authors.forename: Hanjong
authors.initials: H
authors.lastname: Ahn
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007610:Kallikreins / Q000097:blood; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000188:drug therapy*; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000639:trends; D011471:Prostatic Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen
keywords: HMG-CoA reductase inhibitor; biochemical recurrence; prognosis; prostate cancer; radical prostatectomy; statin