title: Statin use and kidney cancer outcomes: A propensity score analysis.
abstract: Studies evaluating the association between statin use and survival outcomes in renal cell carcinoma have demonstrated conflicting results. Our objective was to evaluate this association in a large clinical cohort by using propensity score methods to reduce confounding from measured covariates.
  
  
  
  We performed a retrospective review of 893 patients undergoing nephrectomy for unilateral, M0 renal cell carcinoma between 2000 and 2014 at a tertiary academic center. Inverse probability of treatment weights were derived from a propensity score model based on clinical, surgical, and pathological characteristics. We used Cox proportional hazard models to evaluate the association between statin use and disease-free survival, cancer-specific survival, and overall survival in the sample weighted by the inverse probability of treatment weights. A secondary analysis was performed matching statin users 1:1 to statin nonusers on the propensity score.
  
  
  
  Of the 893 patients, 259 (29%) were on statins at the time of surgery. Median follow-up was 47 months (interquartile range: 20-80). Statin use was not significantly associated with disease-free survival (hazard ratio [HR] = 1.09, 95% CI: 0.65-1.81), cancer-specific survival (HR = 0.90, 95% CI: 0.40-2.01), or overall survival (HR = 0.89, 95% CI: 0.55-1.44). Similar results were observed when using propensity score matching.
  
  
  
  The present study found no significant association between statin use and kidney cancer outcomes. Population-based studies are needed to further evaluate the role of statins in kidney cancer therapy.
authors.affiliation: Department of Surgery, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Canada; Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Canada.
authors.forename: Madhur
authors.initials: M
authors.lastname: Nayan
authors.affiliation: Department of Surgery, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Canada; Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Canada.
authors.forename: Antonio
authors.initials: A
authors.lastname: Finelli
authors.affiliation: Department of Surgery, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Canada; Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Canada.
authors.forename: Michael A S
authors.initials: MAS
authors.lastname: Jewett
authors.affiliation: Department of Internal Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
authors.forename: David N
authors.initials: DN
authors.lastname: Juurlink
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Canada; Institute of Health Management, Policy and Evaluation, University of Toronto, Toronto, Canada; Schulich Heart Research Program, Sunnybrook Research Institute, Toronto, Canada.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Austin
authors.affiliation: Department of Surgery, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Canada; Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Canada.
authors.forename: Girish S
authors.initials: GS
authors.lastname: Kulkarni
authors.affiliation: Department of Surgery, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Canada; Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Canada. Electronic address: rob.hamilton@uhn.ca.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Hamilton
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000401:mortality* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000401:mortality* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D057216:Propensity Score; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: HMG-CoA reductase inhibitor; Kidney neoplasms; Nephrectomy; Propensity score; Survival