title: Statin use and risk of disease recurrence and death after radical prostatectomy.
abstract: BACKGROUND
  Statins have been linked with improved prostate cancer survival and lower risk of recurrence in men treated with radiation therapy. However, the association is unclear for surgically-treated men. We studied the risk of prostate cancer recurrence and death by statin usage after radical prostatectomy in a cohort of prostate cancer patients treated with radical prostatectomy.
  
  
  METHODS
  A cohort of 1,314 men who underwent curative-intent radical prostatectomy at the Tampere University Hospital, Tampere, Finland during 1995-2009 were linked to national prescription database to obtain detailed information on statin purchases. The risk of PSA recurrence and death (overall and prostate cancer-specific) by statin use before and after the surgery were evaluated using Cox regression with model adjustment for tumor characteristics, total cholesterol and simultaneous use of antidiabetic and antihypertensive drugs. Tissue expression of putative prognostic markers were measured from a subgroup of 323 men.
  
  
  RESULTS
  During the median follow-up of 8.6 years after surgery 484 men recurred, while 244 men died (32 due to prostate cancer). In general statin use before or after prostatectomy was not associated with risk of disease recurrence or death. Tissue expression of Ki-67 and ERG modified the association between statin use and risk of disease recurrence; the risk estimates were lower in men with Ki-67 expression above the median (P for interaction 0.001 and 0.004 for statin use before and after prostatectomy, respectively) and no ERG expression in the tumor tissue (P for interaction 0.006 and 0.011).
  
  
  CONCLUSIONS
  Statin use generally did not affect prostate cancer prognosis after prostatectomy. The effect on disease recurrence may depend on tumor properties, such as proliferation activity. Thus possible future prospective studies should recognize and enroll subgroups of prostate cancer patients most likely to benefit from statins.
authors.affiliation: School of Medicine, University of Tampere, Tampere, Finland.
authors.forename: Teemu
authors.initials: T
authors.lastname: Keskiväli
authors.affiliation: Department of Pathology, Fimlab laboratories, Tampere, Finland.
authors.forename: Paula
authors.initials: P
authors.lastname: Kujala
authors.affiliation: Institute of Biomedical Technology, University of Tampere, Tampere, Finland.
authors.forename: Tapio
authors.initials: T
authors.lastname: Visakorpi
authors.affiliation: School of Medicine, University of Tampere, Tampere, Finland.|Department of Urology, Tampere University Hospital, Tampere, Finland.
authors.forename: Teuvo L J
authors.initials: TL
authors.lastname: Tammela
authors.affiliation: School of Medicine, University of Tampere, Tampere, Finland.|Department of Urology, Tampere University Hospital, Tampere, Finland.
authors.forename: Teemu J
authors.initials: TJ
authors.lastname: Murtola
mesh_terms: D000368:Aged; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology*; D011379:Prognosis; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012307:Risk Factors
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: 3-hydroxy-3-methylglutaryl-CoA-reductase inhibitors; disease progression; prostate cancer; tissue markers