Postoperative statin use and risk of biochemical recurrence following radical prostatectomy: Results from the SEARCH database

Objective To investigate the effect of postoperative statin use on biochemical recurrence (BCR) in PC patients treated with radical prostatectomy (RP) who never used statins before surgery. Patients and Methods We conducted a retrospective analysis of 1,146 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 postoperative statin users versus nonusers. To account for varying start dates and duration of statin use during follow-up, postoperative statin use was treated as a time-dependent variable. In secondary analysis, models were stratified by race to examine the association of postoperative statin use with BCR among black and non-black men. Results After adjusting for clinical and pathological characteristics, postoperative statin use was significantly associated with 36% reduced risk of BCR (HR 0.64; 95%CI 0.47-0.87; p=0.004). Postoperative statin use remained associated with reduced risk of BCR after adjusting for preoperative serum cholesterol levels. In secondary analysis, following 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, postoperative statin use was significantly associated with reduced risk of BCR. Whether the association between postoperative 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 PC, randomized controlled trials are warranted to formally test the hypothesis that statins slow PC progression.

Duke Scholars

Author Lauren Howard