Teemu Keskiväli1, Paula Kujala2, Tapio Visakorpi3, Teuvo L J Tammela1,4, Teemu J Murtola1,4. 1. School of Medicine, University of Tampere, Tampere, Finland. 2. Department of Pathology, Fimlab laboratories, Tampere, Finland. 3. Institute of Biomedical Technology, University of Tampere, Tampere, Finland. 4. Department of Urology, Tampere University Hospital, Tampere, Finland.
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.
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 cancerpatients 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 cancerpatients most likely to benefit from statins.
Authors: Christopher J Sweeney; Stephen P Finn; Lorelei A Mucci; Emma H Allott; Ericka M Ebot; Konrad H Stopsack; Amparo G Gonzalez-Feliciano; Sarah C Markt; Kathryn M Wilson; Thomas U Ahearn; Travis A Gerke; Mary K Downer; Jennifer R Rider; Stephen J Freedland; Tamara L Lotan; Philip W Kantoff; Elizabeth A Platz; Massimo Loda; Meir J Stampfer; Edward Giovannucci Journal: Clin Cancer Res Date: 2019-11-21 Impact factor: 12.531
Authors: Tamara L Lotan; Alba Torres; Miao Zhang; Jeffrey J Tosoian; Liana B Guedes; Helen Fedor; Jessica Hicks; Charles M Ewing; Sarah D Isaacs; Dorhyun Johng; Angelo M De Marzo; William B Isaacs Journal: Oncotarget Date: 2017-04-04