Statin use is associated with improved survival in patients undergoing surgery for renal cell carcinoma.
Statin use is associated with improved survival in patients undergoing surgery for renal cell carcinoma.
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DOI：
10.1016/j.urolonc.2014.10.007
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发表时间：
2015-01
期刊：
影响因子：
--
通讯作者：
Clark PE
中科院分区：
文献类型：
--
作者：
Kaffenberger SD;Lin-Tsai O;Stratton KL;Morgan TM;Barocas DA;Chang SS;Cookson MS;Herrell SD;Smith JA Jr;Clark PE
确定手术时使用他汀类药物是否与肾细胞癌（RCC）患者肾切除术或肾部分切除术后的生存率相关。他汀类药物被认为对许多恶性肿瘤的癌症发病率和可能的癌症存活率具有保护作用;迄今为止，没有研究表明他汀类药物的使用与RCC死亡率之间存在独立关联。对2000-2010年在一家机构接受肾癌根治性或部分肾切除术的916例患者进行了回顾性队列研究。主要结局为总体（OS）和疾病特异性生存期（DSS）。使用Kaplan-Meier和对数秩方法进行单变量生存分析。采用考克斯比例风险模型进行多变量分析。用Harrell的c指数评估模型的预测区分度。整个队列的中位随访时间为42.5个月。他汀类药物使用者的3年OS估计值为83.1%（95%CI，77.6-87.3%），非他汀类药物使用者为77.3%（95%CI，73.7-80.6%）（p=0.53）。他汀类药物使用者的3年DSS为90.9%（95%CI，86.3-94.0%），非他汀类药物使用者为83.5%（95%CI，80.1-86.3%）（p=0.015）。在控制年龄、阿萨分级、pT分期、pN分期、转移状态、术前贫血和纠正的高钙血症以及血型后，手术时使用他汀类药物与OS（HR 0.62，95%CI 0.43-0.90; p=0.011）和DSS（HR 0.48，95%CI 0.28-0.83; p=0.009）改善独立相关。DSS的多变量模型具有良好的预测区分度，c指数为0.91。这些数据表明，他汀类药物在手术时的使用是独立相关的改善OS和DSS的患者接受手术的RCC。
To determine whether statin use at time of surgery is associated with survival following nephrectomy or partial nephrectomy for renal cell carcinoma (RCC). Statins are thought to exhibit a protective effect on cancer incidence and possibly cancer survival in a number of malignancies; to date, no studies have shown an independent association between statin use and mortality in RCC. A retrospective cohort study of 916 patients who underwent radical or partial nephrectomy for RCC from 2000–2010 at a single institution was performed. Primary outcomes were overall (OS) and disease-specific survival (DSS). Univariable survival analyses were performed using the Kaplan-Meier and log-rank methods. Multivariable analysis was performed using a Cox proportional hazards model. The predictive discrimination of the models was assessed with Harrell’s c-index. Median follow-up of the entire cohort was 42.5 months. The three-year OS estimate was 83.1% (95%CI, 77.6–87.3%) for statin users and 77.3% (95%CI, 73.7–80.6%) for non-statin users (p=0.53). Three-year DSS was 90.9% (95%CI, 86.3–94.0%) for statin users and 83.5% (95%CI, 80.1–86.3%) for non-statin users (p=0.015). After controlling for age, ASA class, pT stage, pN stage, metastatic status, pre-operative anemia and corrected hypercalcemia, and blood type, statin use at time of surgery was independently associated with improved OS (HR 0.62, 95%CI 0.43–0.90; p=0.011) and DSS (HR 0.48, 95%CI 0.28–0.83; p=0.009). The multivariable model for DSS had excellent predictive discrimination with a c-index of 0.91. These data suggest that statin usage at time of surgery is independently associated with improved OS and DSS in patients undergoing surgery for RCC.
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DOI：
10.1038/nrurol.2010.47
发表时间：
2010-05
期刊：
Nature reviews. Urology
影响因子：
--
作者：
通讯作者：
--
影响因子：
11.5
作者：
Cho, Daniel;Signoretti, Sabina;Atkins, Michael B.
通讯作者：
Atkins, Michael B.
影响因子：
10.3
作者：
Platz, Elizabeth A.;Leitzmann, Michael F.;Giovannucci, Edward
通讯作者：
Giovannucci, Edward
影响因子：
45.3
作者：
Kutikov, Alexander;Egleston, Brian L.;Uzzo, Robert G.
通讯作者：
Uzzo, Robert G.
影响因子：
6.6
作者：
Hamilton, Robert J.;Morilla, Daniel;Cabrera, Fernando;Leapman, Michael;Chen, Ling Y.;Bernstein, Melanie;Hakimi, A. Ari;Reuter, Victor E.;Russo, Paul
通讯作者：
Russo, Paul