145 PREOPERATIVE STATIN USE ASSOCIATED WITH LOWER PSA BUT SIMILAR HISTOPATHOLOGIC OUTCOMES

Abstract

You have accessJournal of UrologyProstate Cancer: Epidemiology and Natural History1 Apr 2011145 PREOPERATIVE STATIN USE ASSOCIATED WITH LOWER PSA BUT SIMILAR HISTOPATHOLOGIC OUTCOMES Hugh Lavery, Adele Hobbs, Mazyar Ghanaat, Adam Levinson, and David Samadi Hugh LaveryHugh Lavery New York, NY More articles by this author , Adele HobbsAdele Hobbs New York, NY More articles by this author , Mazyar GhanaatMazyar Ghanaat New York, NY More articles by this author , Adam LevinsonAdam Levinson New York, NY More articles by this author , and David SamadiDavid Samadi New York, NY More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.213AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The impact of statins in the development and possible chemoprevention of prostate cancer remains controversial. Some reports suggest that men on statins are diagnosed with prostate cancer less frequently and may develop biochemical recurrence less frequently following prostatectomy. Others have reported that statins may reduce serum PSA. We stratified men in a large prostatectomy database by preoperative statin use and analyzed their clinicopathologic features in an attempt to further define possible associations with statin use. METHODS Patients undergoing robotic-assisted laparoscopic prostatectomy (RALP) from May 2004 until September 2010 (n=1642) were dichotomized according to preoperative statin use. Baseline and histopathologic outcomes were compared between those using any statin medication at the time of RALP (n=521) and those who were not (n=1121). Biochemical recurrence was defined as a single PSA>0.2 after surgery. RESULTS The 521 patients (32%) taking statins at the time of prostatectomy were older (61 vs 59 years, p<0.001), had higher body mass index (BMI; 27.8 vs 27.4 kg/m2, p=0.05) and more comorbidities as measured by American Society of Anesthesiology (ASA) scores than statin non-users. Preoperative Gleason scores, clinical staging and D'Amico risk stratification were similar between the two groups, but men on statins had significantly lower mean PSA (5.5 vs 6.4, p<0.001). Pathologic stage, margin status, Gleason scores and prostate weight were similar between the two groups. Biochemical recurrence rate was also similar at a mean follow-up of 16 months for both groups. CONCLUSIONS Men taking statins at the time of prostatectomy had significantly lower serum PSA despite being older and having similar sized prostates, supporting prior studies suggesting a PSA reduction effect of statins. The clinically insignificant increase in BMI is unlikely to have contributed a hemodilution affect. Statin users had identical histopathologic and short term oncologic outcomes as non-users. Previously described chemoprevention may be due to direct effects in reducing serum PSA and subsequent “prevention” of prostate biopsy. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e61 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Metrics Author Information Hugh Lavery New York, NY More articles by this author Adele Hobbs New York, NY More articles by this author Mazyar Ghanaat New York, NY More articles by this author Adam Levinson New York, NY More articles by this author David Samadi New York, NY More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...