The association of statin therapy with clinicopathologic outcomes and survival among patients with localized renal cell carcinoma undergoing nephrectomy

Boyd R. Viers, R. Houston Thompson, Sarah P. Psutka, Christine M. Lohse, John C. Cheville, Bradley C. Leibovich, Matthew K. Tollefson, Stephen A. Boorjian

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Abstract

OBJECTIVES: Although statins have been found to induce apoptosis and demonstrate antimetastases activity both in vitro and in vivo for renal cell carcinoma (RCC), clinical evidence of a role for these medications is limited. We evaluated the association of statin therapy with outcomes among patients with surgically treated localized RCC.

METHODS AND MATERIALS: We reviewed 2,357 patients who underwent nephrectomy between 1995 and 2009 for pNx/0, M0 RCC. Of these, 630 (27%) were taking statins within 3 months of surgery. Progression-free survival, cancer-specific survival, and overall survival were estimated using the Kaplan-Meier method. The associations of statin use with clinicopathologic outcomes were evaluated with multivariable logistic and proportional hazards regression models.

RESULTS: Statin therapy at the time of nephrectomy was not significantly associated with the risks of locally advanced (pT3-4) pathologic tumor stage (odds ratio = 0.96; P = 0.80) or high (3-4) tumor grade (odds ratio = 1.11; P = 0.30). Median postoperative follow-up was 7.8 years. Compared with patients not on statin therapy, patients taking statins at surgery had similar 10-year progression-free survival (80% vs. 79%; P = 0.56), cancer-specific survival (85% vs. 84%; P = 0.71), and overall survival (59% vs. 64%; P = 0.11). On multivariable analysis, statin use was not significantly associated with the risks of disease progression (hazard ratio [HR] = 1.22; P = 0.10), death from RCC (HR = 1.02; P = 0.90), or all-cause mortality (HR = 0.84; P = 0.05).

CONCLUSIONS: We found no independent association between preoperative statin therapy and oncologic outcomes among patients with surgically treated localized RCC. Our data thus do not support an anticancer role for statin therapy in this setting.

Original languageEnglish (US)
JournalUrologic Oncology
Volume33
Issue number9
DOIs
StatePublished - Sep 1 2015

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Nephrectomy
Renal Cell Carcinoma
Survival
Therapeutics
Disease-Free Survival
Neoplasms
Odds Ratio
Proportional Hazards Models
Disease Progression
Apoptosis

Keywords

  • HGM-CoA reductase inhibitor
  • localized
  • Nephrectomy
  • Renal cell carcinoma
  • Statin

ASJC Scopus subject areas

  • Medicine(all)

Cite this

The association of statin therapy with clinicopathologic outcomes and survival among patients with localized renal cell carcinoma undergoing nephrectomy. / Viers, Boyd R.; Houston Thompson, R.; Psutka, Sarah P.; Lohse, Christine M.; Cheville, John C.; Leibovich, Bradley C.; Tollefson, Matthew K.; Boorjian, Stephen A.

In: Urologic Oncology, Vol. 33, No. 9, 01.09.2015.

Research output: Contribution to journalArticle

Viers, Boyd R. ; Houston Thompson, R. ; Psutka, Sarah P. ; Lohse, Christine M. ; Cheville, John C. ; Leibovich, Bradley C. ; Tollefson, Matthew K. ; Boorjian, Stephen A. / The association of statin therapy with clinicopathologic outcomes and survival among patients with localized renal cell carcinoma undergoing nephrectomy. In: Urologic Oncology. 2015 ; Vol. 33, No. 9.
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abstract = "OBJECTIVES: Although statins have been found to induce apoptosis and demonstrate antimetastases activity both in vitro and in vivo for renal cell carcinoma (RCC), clinical evidence of a role for these medications is limited. We evaluated the association of statin therapy with outcomes among patients with surgically treated localized RCC.METHODS AND MATERIALS: We reviewed 2,357 patients who underwent nephrectomy between 1995 and 2009 for pNx/0, M0 RCC. Of these, 630 (27{\%}) were taking statins within 3 months of surgery. Progression-free survival, cancer-specific survival, and overall survival were estimated using the Kaplan-Meier method. The associations of statin use with clinicopathologic outcomes were evaluated with multivariable logistic and proportional hazards regression models.RESULTS: Statin therapy at the time of nephrectomy was not significantly associated with the risks of locally advanced (pT3-4) pathologic tumor stage (odds ratio = 0.96; P = 0.80) or high (3-4) tumor grade (odds ratio = 1.11; P = 0.30). Median postoperative follow-up was 7.8 years. Compared with patients not on statin therapy, patients taking statins at surgery had similar 10-year progression-free survival (80{\%} vs. 79{\%}; P = 0.56), cancer-specific survival (85{\%} vs. 84{\%}; P = 0.71), and overall survival (59{\%} vs. 64{\%}; P = 0.11). On multivariable analysis, statin use was not significantly associated with the risks of disease progression (hazard ratio [HR] = 1.22; P = 0.10), death from RCC (HR = 1.02; P = 0.90), or all-cause mortality (HR = 0.84; P = 0.05).CONCLUSIONS: We found no independent association between preoperative statin therapy and oncologic outcomes among patients with surgically treated localized RCC. Our data thus do not support an anticancer role for statin therapy in this setting.",
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T1 - The association of statin therapy with clinicopathologic outcomes and survival among patients with localized renal cell carcinoma undergoing nephrectomy

AU - Viers, Boyd R.

AU - Houston Thompson, R.

AU - Psutka, Sarah P.

AU - Lohse, Christine M.

AU - Cheville, John C.

AU - Leibovich, Bradley C.

AU - Tollefson, Matthew K.

AU - Boorjian, Stephen A.

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N2 - OBJECTIVES: Although statins have been found to induce apoptosis and demonstrate antimetastases activity both in vitro and in vivo for renal cell carcinoma (RCC), clinical evidence of a role for these medications is limited. We evaluated the association of statin therapy with outcomes among patients with surgically treated localized RCC.METHODS AND MATERIALS: We reviewed 2,357 patients who underwent nephrectomy between 1995 and 2009 for pNx/0, M0 RCC. Of these, 630 (27%) were taking statins within 3 months of surgery. Progression-free survival, cancer-specific survival, and overall survival were estimated using the Kaplan-Meier method. The associations of statin use with clinicopathologic outcomes were evaluated with multivariable logistic and proportional hazards regression models.RESULTS: Statin therapy at the time of nephrectomy was not significantly associated with the risks of locally advanced (pT3-4) pathologic tumor stage (odds ratio = 0.96; P = 0.80) or high (3-4) tumor grade (odds ratio = 1.11; P = 0.30). Median postoperative follow-up was 7.8 years. Compared with patients not on statin therapy, patients taking statins at surgery had similar 10-year progression-free survival (80% vs. 79%; P = 0.56), cancer-specific survival (85% vs. 84%; P = 0.71), and overall survival (59% vs. 64%; P = 0.11). On multivariable analysis, statin use was not significantly associated with the risks of disease progression (hazard ratio [HR] = 1.22; P = 0.10), death from RCC (HR = 1.02; P = 0.90), or all-cause mortality (HR = 0.84; P = 0.05).CONCLUSIONS: We found no independent association between preoperative statin therapy and oncologic outcomes among patients with surgically treated localized RCC. Our data thus do not support an anticancer role for statin therapy in this setting.

AB - OBJECTIVES: Although statins have been found to induce apoptosis and demonstrate antimetastases activity both in vitro and in vivo for renal cell carcinoma (RCC), clinical evidence of a role for these medications is limited. We evaluated the association of statin therapy with outcomes among patients with surgically treated localized RCC.METHODS AND MATERIALS: We reviewed 2,357 patients who underwent nephrectomy between 1995 and 2009 for pNx/0, M0 RCC. Of these, 630 (27%) were taking statins within 3 months of surgery. Progression-free survival, cancer-specific survival, and overall survival were estimated using the Kaplan-Meier method. The associations of statin use with clinicopathologic outcomes were evaluated with multivariable logistic and proportional hazards regression models.RESULTS: Statin therapy at the time of nephrectomy was not significantly associated with the risks of locally advanced (pT3-4) pathologic tumor stage (odds ratio = 0.96; P = 0.80) or high (3-4) tumor grade (odds ratio = 1.11; P = 0.30). Median postoperative follow-up was 7.8 years. Compared with patients not on statin therapy, patients taking statins at surgery had similar 10-year progression-free survival (80% vs. 79%; P = 0.56), cancer-specific survival (85% vs. 84%; P = 0.71), and overall survival (59% vs. 64%; P = 0.11). On multivariable analysis, statin use was not significantly associated with the risks of disease progression (hazard ratio [HR] = 1.22; P = 0.10), death from RCC (HR = 1.02; P = 0.90), or all-cause mortality (HR = 0.84; P = 0.05).CONCLUSIONS: We found no independent association between preoperative statin therapy and oncologic outcomes among patients with surgically treated localized RCC. Our data thus do not support an anticancer role for statin therapy in this setting.

KW - HGM-CoA reductase inhibitor

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KW - Renal cell carcinoma

KW - Statin

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