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Postoperative statin use and risk of biochemical recurrence following radical prostatectomy: results from the Shared Equal Access Regional Cancer Hospital (SEARCH) database.

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Date
2014-11
Authors
Allott, EH
Howard, LE
Cooperberg, MR
Kane, CJ
Aronson, WJ
Terris, MK
Amling, CL
Freedland, SJ
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Abstract
OBJECTIVE: To investigate the effect of statin use after radical prostatectomy (RP) on biochemical recurrence (BCR) in patients with prostate cancer who never received statins before RP. PATIENTS AND METHODS: We conducted a retrospective analysis of 1146 RP patients within the Shared Equal Access Regional Cancer Hospital (SEARCH) database. Multivariable Cox proportional hazards analyses were used to examine differences in risk of BCR between post-RP statin users vs nonusers. To account for varying start dates and duration of statin use during follow-up, post-RP statin use was treated as a time-dependent variable. In a secondary analysis, models were stratified by race to examine the association of post-RP statin use with BCR among black and non-black men. RESULTS: After adjusting for clinical and pathological characteristics, post-RP statin use was significantly associated with 36% reduced risk of BCR (hazard ratio [HR] 0.64, 95% confidence interval [CI] 0.47-0.87; P = 0.004). Post-RP statin use remained associated with reduced risk of BCR after adjusting for preoperative serum cholesterol levels. In secondary analysis, after stratification by race, this protective association was significant in non-black (HR 0.49, 95% CI 0.32-0.75; P = 0.001) but not black men (HR 0.82, 95% CI 0.53-1.28; P = 0.384). CONCLUSION: In this retrospective cohort of men undergoing RP, post-RP statin use was significantly associated with reduced risk of BCR. Whether the association between post-RP statin use and BCR differs by race requires further study. Given these findings, coupled with other studies suggesting that statins may reduce risk of advanced prostate cancer, randomised controlled trials are warranted to formally test the hypothesis that statins slow prostate cancer progression.
Type
Journal article
Subject
biochemical recurrence
cholesterol
postoperative statin use
prostate cancer
Aged
Databases, Factual
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Male
Middle Aged
Neoplasm Recurrence, Local
Postoperative Period
Proportional Hazards Models
Prostatectomy
Prostatic Neoplasms
Retrospective Studies
Risk
United States
Permalink
https://hdl.handle.net/10161/8617
Published Version (Please cite this version)
10.1111/bju.12720
Publication Info
Allott, EH; Howard, LE; Cooperberg, MR; Kane, CJ; Aronson, WJ; Terris, MK; ... Freedland, SJ (2014). Postoperative statin use and risk of biochemical recurrence following radical prostatectomy: results from the Shared Equal Access Regional Cancer Hospital (SEARCH) database. BJU Int, 114(5). pp. 661-666. 10.1111/bju.12720. Retrieved from https://hdl.handle.net/10161/8617.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
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Scholars@Duke

Howard

Lauren Howard

Biostatistician, Senior
Lauren collaborates with different investigators in the Duke Cancer Institute on retrospective studies and clinical trials. She has experience with data management, data analysis, and preparation and editing of manuscripts. Some of her past projects have involved time-varying covariates, competing risks, and repeated measures. She is interested in methods for handling bias and confounding in observational research.
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