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Meta-Analysis
. 2013 Jun;24(6):1427-34.
doi: 10.1093/annonc/mdt077. Epub 2013 Mar 18.

Statins and prostate cancer recurrence following radical prostatectomy or radiotherapy: a systematic review and meta-analysis

H S Park  1 , J D Schoenfeld, R B Mailhot, M Shive, R I Hartman, R Ogembo, L A Mucci
Affiliations
Meta-Analysis

Statins and prostate cancer recurrence following radical prostatectomy or radiotherapy: a systematic review and meta-analysis

H S Park et al. Ann Oncol. 2013 Jun.

Abstract

Background: In this meta-analysis, we evaluated associations between statins and recurrence-free survival (RFS) following treatment of localized prostate cancer, with attention to potential benefits among patients treated primarily with radiotherapy (RT) versus radical prostatectomy.

Patients and methods: We identified original studies examining the effect of statins on men who received definitive treatment of localized prostate cancer using a systematic search of the PubMed and EMBASE databases through August 2012. Our search yielded 17 eligible studies from 794 references; 13 studies with hazard ratios (HRs) for RFS were included in the formal meta-analysis.

Results: Overall, statins did not affect RFS (HR 0.90, 95% CI 0.74-1.08). However, in RT patients (six studies), statins were associated with a statistically significant improvement in RFS (HR 0.68; 95% CI 0.49-0.93); this benefit was not observed in radical prostatectomy patients (seven studies). Sensitivity analyses suggested that primary treatment modality may impact the effect of statins on prostate cancer recurrence.

Conclusions: Our meta-analysis suggests a potentially beneficial effect of statins on prostate cancer patients treated with RT but not among radical prostatectomy patients. Although limited by the lack of randomized data, these results suggest that primary treatment modality should be considered in future studies examining associations between statins and oncologic outcomes.

Keywords: meta-analysis; prostate cancer; radical prostatectomy; radiotherapy; recurrence; statin.

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Figures

Figure 1.
Figure 1.
Literature search flow diagram based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement [32].
Figure 2.
Figure 2.
Meta-analysis of studies investigating association of statins with recurrence-free survival (RFS), stratified by primary treatment modality. Hazard ratios (HRs) and 95% confidence intervals (CIs) are reported on a logarithmic scale. Pooled estimates are from a random-effects model. RT, radiotherapy; RP, radical prostatectomy.
Figure 3.
Figure 3.
Publication bias assessed by the funnel plot.
See this image and copyright information in PMC

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References

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