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Statin use during surgery improves survival in renal cell carcinoma
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Statin use at the time of surgery was independently associated with improved disease-specific survival and OS rates in patients with renal cell carcinoma, according to the results of a retrospective cohort study.
“Despite plausible mechanistic links for a protective role of statins in the development of cancer, epidemiologic studies evaluating the association between statin use and cancer risk have been controversial,” Peter E. Clark, MD, of the department of urologic surgery at Vanderbilt University Medical Center, and colleagues wrote. “Although earlier studies had suggested an increased risk of cancer associated with statin use, other studies have reported a neutral effect and the remaining have described protective effects for some cancers up to a 50% RR reduction for cancer incidence.”
Peter E. Clark
Clark and colleagues conducted a retrospective analysis of 916 consecutive patients with renal cell carcinoma. The median age of the population was 60.8 years and the cohort was 65% male. All patients underwent radical or partial nephrectomy at Vanderbilt University Medical Center between 2000 and 2010.
Twenty-nine percent of patients (n = 270) reported statin use at the time of surgery.
Median follow-up was 42.5 months.
Across the entire cohort, 3-year OS was 79% (95% CI, 76-81.6). The 3-year OS rate was 83.1% (95% CI, 77.6-87.3) among statin users and 77.3% (95% CI, 73.7-80.6) among nonusers. Statin users demonstrated a 3-year disease-specific survival rate of 90.9% (95% CI, 86.3-94) vs. a 83.5% (95% CI, 80.1-86.3) 3-year disease-specific survival rate for nonstatin users (P = .015).
Statin use was not statistically associated with OS in the univariable analysis (HR = 0.91; 95% CI, 0.68-1.21). However, results of the multivariable analysis — adjusted for factors such as age, higher stage and grade, metastatic disease and preoperative anemia — indicated statin use was significantly and independently associated with improved OS (HR = 0.62; 95% CI, 0.43-0.9) and disease-specific survival (HR = 0.48; 95% CI, 0.28-0.83).
Researchers conducted exploratory multivariable survival analyses for 582 patients with locoregional disease. After a median follow-up of 42.8 months, 104 overall deaths and 45 disease-specific deaths had occurred. Statin use remained a statistically significant factor for OS (HR = 0.31; 95% CI, 0.13-0.73) and disease-specific survival (HR = 0.63; 95% CI, 0.4-0.97).
Researchers acknowledged the lack of data on length and dosage of statin use in individual participants is a limitation to these findings.
“Our data suggest that statin use at the time of surgery is independently associated with improved OS and disease-specific survival,” Clark said in a press release. “This study is among the first research confirming a survival advantage for patients who are taking these drugs.” – by Cameron Kelsall
Disclosure: HemOnc Today could not verify the researchers’ relevant financial disclosures at the time of reporting.
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