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Outcomes of Statin Use in Veterans with Prostate Cancer: A Retrospective Single-Center Experience


 

Background: Prostate cancer is the most common cancer in men in the United States. Death in prostate cancer patients is often reported to be non-prostate cancer related, attributed to other medical conditions, cardiovascular disease, or malignancies. As prostate cancer is associated with a prolonged survival, especially in those with low burden of disease, care of these patients includes not only treating their malignancy, but also optimizing their other co-morbidities, such as cardiovascular disease. Statins are lipid-lowering medications, proven to reduce mortality in cardiovascular disease. There are multiple reports and epidemiological studies of statins decreasing the risk, progression, and overall mortality of prostate cancer. Methods: This is a retrospective observational study with chart review of 300 patients diagnosed with prostate cancer from 1995 to 2010, in a VA Hospital in San Antonio, Texas. Variables included age of diagnosis, statin use, type of statin (1st, 2nd, or 3rd generation), dose of statin (6 levels of dosage were identified), length of statin use, time followed in months (from time of diagnosis to either death or the end of the study period), death, and cause of death. The Cox proportional hazards regression model was used to estimate the hazard function, with age at diagnosis used as a covariate. Primary end point was death by prostate cancer (21 patients) and secondary end points- death by any cancer (52 patients patients), and death by all causes (136 patients). Results: The hazard ratio for use of statins at least 6 months was 0.33, with 95% confidence limits of 0.13 to 0.83, and P = 0.018, indicating that using statins has a statistically significant positive effect at delaying death by prostate cancer. Secondary endpoints of death by any cancer and death by all causes were also significantly affected by the statins. The study was unable to conclude if the type of statin, dose of statin or the length of statin use had a significant effect in reaching the different end points.

Conclusion: Concomitant statin use may prevent death from prostate cancer, death from any cancer, as well as death from all causes.

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