基于人群的患者队列研究中他汀类药物的使用与前列腺癌结局的关系。
Statin use in relation to prostate cancer outcomes in a population-based patient cohort study.
机构信息
Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands.
出版信息
Prostate. 2013 Aug;73(11):1214-22. doi: 10.1002/pros.22671. Epub 2013 Apr 30.
BACKGROUND
We investigated associations between statin use begun before prostate cancer (PCa) diagnosis and PCa recurrence/progression and PCa-specific mortality (PCSM) in a prospective, population-based cohort study.
METHODS
The analysis included 1,001 PCa patients diagnosed in 2002-2005 in King County, Washington. Statin use was assessed at the time of diagnosis using a detailed in-person interview. Prostate cancer recurrence/progression events and cause-specific survival were ascertained from a follow-up survey and the SEER registry. Multivariable competing risk and Cox proportional hazards regression models were used to assess the risk of PCa outcomes according to categories of statin use.
RESULTS
Of the 1,001 PCa patients in our study, 289 men were ever users of statin drugs. During follow-up, we identified 151 PCa recurrence/progression events and 123 total deaths, including 39 PCa-specific deaths. In unadjusted analysis, the risk of PCSM was significantly lower for statin users compared to non-users (1% vs. 5% at 10 years; P < 0.01). In multivariable analysis, the adjusted hazard ratio of PCSM for statin users versus non-users was 0.19 (95% CI: 0.06, 0.56). Statin use was not associated with overall PCa recurrence/progression and other-cause mortality.
CONCLUSIONS
Statin use begun before PCa diagnosis was unrelated to PCa recurrence/progression but was associated with a decrease in risk of PCSM.
背景
我们在一项前瞻性、基于人群的队列研究中，调查了前列腺癌（PCa）诊断前开始使用他汀类药物与 PCa 复发/进展和 PCa 特异性死亡率（PCSM）之间的关系。
方法
该分析包括 2002-2005 年在华盛顿州金县诊断的 1001 例 PCa 患者。使用详细的面对面访谈评估诊断时他汀类药物的使用情况。通过随访调查和 SEER 登记处确定前列腺癌复发/进展事件和死因特异性生存率。使用多变量竞争风险和 Cox 比例风险回归模型，根据他汀类药物使用类别评估 PCa 结局的风险。
结果
在我们的研究中，1001 例 PCa 患者中有 289 例曾使用过他汀类药物。在随访期间，我们确定了 151 例 PCa 复发/进展事件和 123 例总死亡事件，包括 39 例 PCa 特异性死亡。在未调整分析中，与非使用者相比，他汀类药物使用者的 PCSM 风险显著降低（10 年时为 1%比 5%；P<0.01）。在多变量分析中，与非使用者相比，他汀类药物使用者的 PCSM 调整后的风险比为 0.19（95%CI：0.06，0.56）。他汀类药物的使用与总体 PCa 复发/进展和其他原因死亡率无关。
结论
PCa 诊断前开始使用他汀类药物与 PCa 复发/进展无关，但与 PCSM 风险降低相关。
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