Statins may reduce recurrence risk after radical prostatectomy

Statins may reduce the risk of biochemical prostrate cancer recurrence after radical prostatectomy, according to a new study.

Researchers used data from five Veterans Administration Medical Centers to examine whether statin use was associated with outcomes in men who had had radical prostatectomy. Time to prostate-specific antigen (PSA) recurrence was compared in men who were taking statins (n=236) and those who were not (n=1,083). The study results were published early online June 28 and will appear in the July 15 Cancer.

Statin users were followed for a median of 24 months, while nonstatin users were followed for a median of 38 months. Men taking statins tended to be older and heavier and to have had radical prostatectomy more recently than those not taking statins. They also were diagnosed with prostate cancer at a lower clinical stage and with lower PSA levels but had higher Gleason scores at biopsy. Thirty-seven statin users (16%) and 267 nonusers (25%) had biochemical recurrence during follow-up. Once the authors adjusted for clinical and pathologic factors, risk for PSA recurrence was 30% lower in statin users compared with nonusers (hazard ratio, 0.70; 95% CI, 0.50 to 0.97; P=0.03). This lowered risk was found to be dose dependent, with hazard ratios of 1.08 (95% CI, 0.66 to 1.73) for the equivalent of less than 20 mg of simvastatin, 0.57 (95% CI, 0.32 to 1.00) for the equivalent of 20 mg of simvastatin, and 0.50 (95% CI, 0.27 to 0.93) for the equivalent of more than 20 mg of simvastatin.

The authors pointed out that statin users and nonusers differed significantly, possibly leading to residual confounding, and that the study was not powered to examine prostate cancer deaths or overall mortality, among other limitations. However, they concluded that statins were associated with a dose-dependent lower risk for PSA recurrence in men who had had a radical prostatectomy. They called for further studies in other settings and, if their findings are confirmed, a randomized, controlled trial.

"Given that statins have proven efficacy in preventing cardiovascular mortality, if it is definitively proven that statins reduce recurrence after surgery, then the potential influence statins could have on overall and disease-specific mortality is substantial," they wrote.