Statins Do Not Influence Biochemical Recurrence of Prostate Cancer

Statins did not seem to influence the risk of biochemical recurrence of prostate cancer after radical prostatectomy or radiotherapy in a new meta-analysis.

"These results extend our 'older' meta-analysis, which had incorporated the results of six randomized clinical trials and 13 observational studies and concluded that statins do not cause any substantial change in the risk of prostate cancer," Dr. Stefanos Bonovas from University of Athens, Greece, told Reuters Health by email.

Since Dr. Bonovas's report, several additional cohort studies of statins and prostate cancer incidence were published, prompting a different team of researchers - headed by Dr. Edward Messing at the University of Rochester, New York -- to perform a systematic review and meta-analysis of the observational studies with statin use as the exposure variable and biochemical failure after definitive local therapy as the outcome.

"Unfortunately, advanced prostate cancer was not a documented end-point in the randomized trials of statins," Dr. Messing and his colleagues note in their report, released online September 27 in BJU International.

Of the eight included studies, five followed men who had radical prostatectomy and three followed patients after radiotherapy. Altogether they included 2,812 statin users and 10,031 nonusers.
When all eight studies were considered together, there was no significant difference in the risk of biochemical recurrence between statin users and nonusers, but there was substantial evidence of heterogeneity.

Results from the radical prostatectomy studies were inconsistent, but overall there was no significant difference in the risk of recurrence between statin users and nonusers.
Similarly, the pooled results from the radiotherapy studies favored statins in a fixed effects meta-analysis but not in the random effects meta-analysis.

"Considering limitations of observational studies," the researchers conclude, "it may be appropriate to investigate the effect of statins on prostate cancer recurrence and progression in randomized trials."
Dr. Bonovas agreed: "I am certainly not surprised by these results. However, given that the analysis revealed considerable heterogeneity between the studies, additional research is needed."
In the meantime, he said, "There is now accumulated evidence that statin use does not affect prostate cancer biochemical recurrence. Physicians need to be vigilant in ensuring that the use of statins remains restricted to the approved cardiovascular indications."