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Statin use is associated with decreased prostate cancer recurrence in men treated with brachytherapy

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Abstract

Purpose/objective(s)

Recent in vitro and in vivo evidence has suggested that statin medications may have anticancer activity. We sought to determine whether statin use was associated with improved clinical outcome in men treated with brachytherapy for prostate cancer.

Materials/methods

A database of men with prostate cancer treated with permanent Iodine-125 brachytherapy between January 1999 and February 2009 was retrospectively analyzed. Standard guidelines (i.e., American Brachytherapy Society selection criteria) were used for selecting patients for brachytherapy. Biochemical failure was defined using the Phoenix definition.

Results

From a total of 247 men with prostate adenocarcinoma treated with brachytherapy, 174 patients (70 %) were identified as using statin medications, either during initial visit or during follow-up. Median PSA follow-up was 51 months after date of implant (range 9.4–140.35). Overall biochemical failure rate was 7.3 % (18 patients). On univariate analysis, statin use was associated with significantly improved freedom from biochemical failure [hazard ratio (HR) 0.28; 95 % CI 0.10–0.72; p < 0.01 by log-rank test]. In multivariate Cox analysis performed with the variables statin use, pretreatment PSA, clinical T stage, Gleason score, and D90 or V100, statin use remained significantly associated with improved freedom from biochemical failure (HR 0.288; 95 % CI 0.086–0.886; p = 0.0299).

Conclusions

Statin use was associated with a significant improvement in freedom from biochemical failure in this cohort of men treated with brachytherapy for prostate cancer. Further investigation into the favorable effect of statin use on brachytherapy and radiation therapy in general is warranted, including prospective trials.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

This study was approved by the Durham VA institutional review board and was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Authors and Affiliations

  1. Durham VA Medical Center, Duke University, Durham, NC, USA

    Daniel S. Oh

  2. Department of Radiation Oncology, Durham VA Medical Center, Duke University, DUMC box 3085, Durham, NC, 27710, USA

    Bridget Koontz, Pretesh Patel, Stephen Lewis, David S. Yoo, James Oleson & Joseph K. Salama

  3. Department of Surgery (Urology), Durham VA Medical Center, Duke University, Durham, NC, USA

    Stephen J. Freedland & Leah Gerber

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  1. Daniel S. Oh
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  2. Bridget Koontz
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  3. Stephen J. Freedland
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  4. Leah Gerber
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  5. Pretesh Patel
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  6. Stephen Lewis
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  7. David S. Yoo
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  8. James Oleson
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  9. Joseph K. Salama
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Corresponding author

Correspondence to Joseph K. Salama.

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Oh, D.S., Koontz, B., Freedland, S.J. et al. Statin use is associated with decreased prostate cancer recurrence in men treated with brachytherapy. World J Urol 33, 93–97 (2015). https://doi.org/10.1007/s00345-014-1281-x

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  • DOI: https://doi.org/10.1007/s00345-014-1281-x

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