Postdiagnostic Statin Use and the Risk of Lethal Prostate Cancer in the Health Professionals Follow-up Study.
Postdiagnostic Statin Use and the Risk of Lethal Prostate Cancer in the Health Professionals Follow-up Study.
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DOI：
10.1158/1055-9965.epi-15-0671
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发表时间：
2015-10
期刊：
影响因子：
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通讯作者：
Stampfer MJ
中科院分区：
文献类型：
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作者：
Chan JM;Kenfield SA;Paciorek A;Platz EA;Giovannucci EL;Stampfer MJ
观察性研究表明，他汀类药物对前列腺癌预后具有潜在的化学预防益处，但关于诊断后使用影响的数据很少。我们在1992年至2008年期间的卫生专业人员随访研究中检查了诊断后他汀类药物使用与致死性前列腺癌风险（转移或前列腺癌死亡，N = 242）的相关性，并随访至2010年（33，302人年）。我们使用考克斯比例风险回归模型估计相对风险和95%置信区间（CI），调整年龄、时间段、从诊断到问卷调查的时间、体重指数、剧烈体力活动、吸烟、阿司匹林使用、临床分期、诊断时PSA、Gleason评分、主要治疗和合并症。我们发现诊断后目前使用他汀类药物或他汀类药物使用时间与致死性前列腺癌的结局之间无统计学显著相关性[N = 242例;多变量HR = 0.97（95% CI，0.72-1.31）当前使用是/否; HR = 0.85（95% CI，0.59-1.22）使用1 - 5年，0.96（95% CI，0.66-1.38）使用6年以上vs.从未使用]。我们观察到很少有证据表明，在诊断为局限性前列腺癌后使用他汀类药物可降低进展为转移性疾病或前列腺癌特异性死亡的风险。这些结果不支持他汀类药物作为前列腺癌进展的化学预防剂。
Observational studies suggest potential chemopreventive benefits of statins on prostate cancer outcomes, but data on the impact of postdiagnostic use are sparse. We examined the association of postdiagnostic statin use and risk of lethal prostate cancer (metastases or prostate cancer death, N = 242) among 3,949 men diagnosed with localized prostate cancer from the Health Professionals Follow-Up Study between 1992 and 2008 and followed through 2010 (33,302 person years). We used Cox proportional hazards regression models to estimate relative risks and 95% confidence intervals (CI), adjusting for age, time period, time from diagnosis to questionnaire, body mass index, vigorous physical activity, smoking, aspirin use, clinical stage, PSA at diagnosis, Gleason score, primary treatment, and comorbidities. We found no statistically significant association between postdiagnostic current use of statins or duration of statin usage and the outcome of lethal prostate cancer [N = 242 cases; multivariate HR = 0.97 (95% CI, 0.72–1.31) for current use yes/no; HR = 0.85 (95% CI, 0.59–1.22) for 1 to 5 years of use, 0.96 (95% CI, 0.66–1.38) for 6+ years of use vs. never use]. We observed little evidence that statin usage after diagnosis of localized prostate cancer reduces risk of progression to metastatic disease or prostate cancer–specific death. These results do not support statins as a chemopreventive agent for prostate cancer progression.