title: Statin utilization improves oncologic and survival outcomes in patients with dyslipidemia and surgically treated renal cell carcinoma.
abstract: BACKGROUND
  We evaluated the role of statins in patients who underwent surgery for renal cell carcinoma (RCC) and who had dyslipidemia, as use of statins has been suggested to improve outcomes in RCC.
  
  
  METHODS
  Two-center retrospective study of patients with dyslipidemia who underwent surgery for RCC from 7/1995 to 6/2005. Patients were managed by statins or ezetimibe, fibrate agents, or cholestyramine. Analysis was conducted between patients who received statin therapy versus those that did not. Primary outcome was progression-free survival (PFS). Secondary outcomes were cancer-specific (CSS) and overall survival (OS). Multivariable analysis was performed to identify risk factors associated with disease progression.
  
  
  RESULTS
  In this study 283 patients were analyzed (180 statin, 103 non-statin, median follow-up 68 months). There were no significant demographic differences. Median duration of antidyslipidemia therapy was similar (statin 31 months vs. non-statin 28 months, P=0.413). Tumor size (statin 5.4 cm vs. non-statin 5.6 cm, P=0.569), stage distribution (P=0.591), histology (P=0.801), and grade (P=0.807) were similar. Kaplan-Meier analysis demonstrated higher 5-yr PFS (91% vs. 70%, P<0.001), CSS (88% vs. 69%, P<0.001), and OS (71% vs. 67%, P=0.025) in statin vs. non-statin patients. Multivariable analysis for factors associated with disease progression found absence of statin therapy (OR 2.41, P<0.001), higher stage (OR 2.01-3.86 P<0.001), and higher grade tumors (OR 2.07, P=0.006) to be predictive.
  
  
  CONCLUSIONS
  In RCC patients with dyslipidemia, statin use was associated with improved survival outcomes, and was an independent predictor of PFS. Further investigations are requisite to determine utility of statins in RCC patients.
authors.affiliation: Department of Urology, UC San Diego Health System, La Jolla, CA, USA.
authors.forename: Sean W
authors.initials: SW
authors.lastname: Berquist
authors.affiliation: Department of Urology, UC San Diego Health System, La Jolla, CA, USA.
authors.forename: Hak J
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Department of Urology, UC San Diego Health System, La Jolla, CA, USA.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Hamilton
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Aditya
authors.initials: A
authors.lastname: Bagrodia
authors.affiliation: Department of Urology, UC San Diego Health System, La Jolla, CA, USA.
authors.forename: Abd-Elrahman
authors.initials: AE
authors.lastname: Hassan
authors.affiliation: Department of Urology, UC San Diego Health System, La Jolla, CA, USA.
authors.forename: Alp T
authors.initials: AT
authors.lastname: Beksaç
authors.affiliation: Department of Urology, UC San Diego Health System, La Jolla, CA, USA.
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Dufour
authors.affiliation: Department of Urology, UC San Diego Health System, La Jolla, CA, USA.
authors.forename: Song
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Urology, University of Tennessee Health Science Center, Memphis, TN, USA.
authors.forename: Reza
authors.initials: R
authors.lastname: Mehrazin
authors.affiliation: Department of Urology, University of Tennessee Health Science Center, Memphis, TN, USA.
authors.forename: Anthony
authors.initials: A
authors.lastname: Patterson
authors.affiliation: Department of Urology, UC San Diego Health System, La Jolla, CA, USA - iderweesh@gmail.com.
authors.forename: Ithaar H
authors.initials: IH
authors.lastname: Derweesh
mesh_terms: D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000601:surgery*; D018572:Disease-Free Survival; D050171:Dyslipidemias / Q000150:complications* / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors