Abstract

Objectives: Before launching large clinical trials to confirm the effects of statins in improving outcomes among men with prostate cancer (PC), the most appropriate target patient population and the type of statins need to be clearly identified. Patients and methods: A retrospective cohort study was conducted using the Taiwan Cancer Registry of 2008–2014. This study included 5749 men with locally advanced and metastatic PC who received only androgen deprivation therapy (ADT) in the first year after their cancer diagnosis. Statin users were defined as anyone who was prescribed statins for >28 days. An inverse probability of treatment-weighted Cox model was used to estimate the effects of statin use on all-cause mortality and PC-specific mortality (PCSM) while treating the statin status as a time-dependent variable. Results: Overall, 2259 patients died, and 1495 of them died of PC during a median follow-up of 3.6 years from 1 year after their diagnosis. Statin use was associated with significant reductions in all-cause mortality (hazard ratio [HR] = 0.78, 95% confidence interval [CI]: 0.70–0.86) and PCSM (HR = 0.76, 95% CI: 0.68–0.86) for metastatic disease and all-cause mortality (HR = 0.66, 95% CI: 0.54–0.81) for locally advanced disease. Patients who received atorvastatin, pravastatin, rosuvastatin or pitavastatin showed a stronger reduction in mortality than those who received other statins. Benefits of statins were consistently observed in men who received post-diagnostic statins, even in those with high comorbidities or an old age. Conclusions: Our results suggest that only atorvastatin, pravastatin and rosuvastatin were associated with improved survival in advanced PC patients receiving ADT.

Original languageEnglish
Pages (from-to)109-117
Number of pages9
JournalEuropean Journal of Cancer
Volume112
DOIs
Publication statusPublished - May 1 2019

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Androgens
Prostatic Neoplasms
Mortality
Therapeutics
Pravastatin
Confidence Intervals
Health Services Needs and Demand
Taiwan
Proportional Hazards Models
Registries
Comorbidity
Neoplasms
Cohort Studies
Retrospective Studies
Clinical Trials

Keywords

  • ADT
  • Metastasis
  • Mortality
  • Prostate cancer
  • Statin

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

@article{d9ede9d99b124324a0d719d5fd48b196,
title = "Mortality associated with statins in men with advanced prostate cancer treated with androgen deprivation therapy",
abstract = "Objectives: Before launching large clinical trials to confirm the effects of statins in improving outcomes among men with prostate cancer (PC), the most appropriate target patient population and the type of statins need to be clearly identified. Patients and methods: A retrospective cohort study was conducted using the Taiwan Cancer Registry of 2008–2014. This study included 5749 men with locally advanced and metastatic PC who received only androgen deprivation therapy (ADT) in the first year after their cancer diagnosis. Statin users were defined as anyone who was prescribed statins for >28 days. An inverse probability of treatment-weighted Cox model was used to estimate the effects of statin use on all-cause mortality and PC-specific mortality (PCSM) while treating the statin status as a time-dependent variable. Results: Overall, 2259 patients died, and 1495 of them died of PC during a median follow-up of 3.6 years from 1 year after their diagnosis. Statin use was associated with significant reductions in all-cause mortality (hazard ratio [HR] = 0.78, 95{\%} confidence interval [CI]: 0.70–0.86) and PCSM (HR = 0.76, 95{\%} CI: 0.68–0.86) for metastatic disease and all-cause mortality (HR = 0.66, 95{\%} CI: 0.54–0.81) for locally advanced disease. Patients who received atorvastatin, pravastatin, rosuvastatin or pitavastatin showed a stronger reduction in mortality than those who received other statins. Benefits of statins were consistently observed in men who received post-diagnostic statins, even in those with high comorbidities or an old age. Conclusions: Our results suggest that only atorvastatin, pravastatin and rosuvastatin were associated with improved survival in advanced PC patients receiving ADT.",
keywords = "ADT, Metastasis, Mortality, Prostate cancer, Statin",
author = "Wu, {Szu Yuan} and Fang, {Su Chen} and Shih, {Hung Jen} and Wen, {Yu Chin} and Shao, {Yu Hsuan Joni}",
year = "2019",
month = "5",
day = "1",
doi = "10.1016/j.ejca.2018.11.032",
language = "English",
volume = "112",
pages = "109--117",
journal = "European Journal of Cancer",
issn = "0959-8049",
publisher = "Elsevier Limited",

}

TY - JOUR

T1 - Mortality associated with statins in men with advanced prostate cancer treated with androgen deprivation therapy

AU - Wu, Szu Yuan

AU - Fang, Su Chen

AU - Shih, Hung Jen

AU - Wen, Yu Chin

AU - Shao, Yu Hsuan Joni

PY - 2019/5/1

Y1 - 2019/5/1

N2 - Objectives: Before launching large clinical trials to confirm the effects of statins in improving outcomes among men with prostate cancer (PC), the most appropriate target patient population and the type of statins need to be clearly identified. Patients and methods: A retrospective cohort study was conducted using the Taiwan Cancer Registry of 2008–2014. This study included 5749 men with locally advanced and metastatic PC who received only androgen deprivation therapy (ADT) in the first year after their cancer diagnosis. Statin users were defined as anyone who was prescribed statins for >28 days. An inverse probability of treatment-weighted Cox model was used to estimate the effects of statin use on all-cause mortality and PC-specific mortality (PCSM) while treating the statin status as a time-dependent variable. Results: Overall, 2259 patients died, and 1495 of them died of PC during a median follow-up of 3.6 years from 1 year after their diagnosis. Statin use was associated with significant reductions in all-cause mortality (hazard ratio [HR] = 0.78, 95% confidence interval [CI]: 0.70–0.86) and PCSM (HR = 0.76, 95% CI: 0.68–0.86) for metastatic disease and all-cause mortality (HR = 0.66, 95% CI: 0.54–0.81) for locally advanced disease. Patients who received atorvastatin, pravastatin, rosuvastatin or pitavastatin showed a stronger reduction in mortality than those who received other statins. Benefits of statins were consistently observed in men who received post-diagnostic statins, even in those with high comorbidities or an old age. Conclusions: Our results suggest that only atorvastatin, pravastatin and rosuvastatin were associated with improved survival in advanced PC patients receiving ADT.

AB - Objectives: Before launching large clinical trials to confirm the effects of statins in improving outcomes among men with prostate cancer (PC), the most appropriate target patient population and the type of statins need to be clearly identified. Patients and methods: A retrospective cohort study was conducted using the Taiwan Cancer Registry of 2008–2014. This study included 5749 men with locally advanced and metastatic PC who received only androgen deprivation therapy (ADT) in the first year after their cancer diagnosis. Statin users were defined as anyone who was prescribed statins for >28 days. An inverse probability of treatment-weighted Cox model was used to estimate the effects of statin use on all-cause mortality and PC-specific mortality (PCSM) while treating the statin status as a time-dependent variable. Results: Overall, 2259 patients died, and 1495 of them died of PC during a median follow-up of 3.6 years from 1 year after their diagnosis. Statin use was associated with significant reductions in all-cause mortality (hazard ratio [HR] = 0.78, 95% confidence interval [CI]: 0.70–0.86) and PCSM (HR = 0.76, 95% CI: 0.68–0.86) for metastatic disease and all-cause mortality (HR = 0.66, 95% CI: 0.54–0.81) for locally advanced disease. Patients who received atorvastatin, pravastatin, rosuvastatin or pitavastatin showed a stronger reduction in mortality than those who received other statins. Benefits of statins were consistently observed in men who received post-diagnostic statins, even in those with high comorbidities or an old age. Conclusions: Our results suggest that only atorvastatin, pravastatin and rosuvastatin were associated with improved survival in advanced PC patients receiving ADT.

KW - ADT

KW - Metastasis

KW - Mortality

KW - Prostate cancer

KW - Statin

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U2 - 10.1016/j.ejca.2018.11.032

DO - 10.1016/j.ejca.2018.11.032

M3 - Article

AN - SCOPUS:85062104722

VL - 112

SP - 109

EP - 117

JO - European Journal of Cancer

JF - European Journal of Cancer

SN - 0959-8049

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