Statins, Especially Atorvastatin, May Improve Survival Following Brachytherapy for Clinically Localized Prostate Cancer

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Abstract

Objective

To determine if statin usage impacts cause-specific, biochemical progression-free, and/or overall survival following brachytherapy for clinically localized prostate cancer.

Materials and Methods

From April 1995 through June 2002, 938 consecutive patients were treated with brachytherapy for clinical stage T1b-T3a NxM0 prostate cancer. All patients underwent brachytherapy more than 3 years prior to analysis. Of the evaluated cohort, statin usage was documented in 191 patients. The median followup was 5.4 years. Multiple clinical, treatment, and dosimetric parameters were evaluated as predictors of cause-specific, biochemical progression-free, and overall survival.

Results

At presentation, statin usage resulted in significantly lower pre-treatment prostate-specific antigen values, percentage of positive biopsies and prostate volume. Nine-year cause-specific, biochemical progression-free, and overall survival for the entire cohort was 96.4%, 95.9%, and 78.1% respectively. Statin usage resulted in a nonstatistical improvement in all survival parameters with the results most pronounced for atorvastatin. In Cox regression analysis, cause-specific survival was best predicted by Gleason score while biochemical progression-free survival was most closely related to percent-positive biopsies, prostate volume, and risk group. Overall survival most closely correlated with patient age, V100′, and tobacco usage.

Conclusions

Statins, especially atorvastatin, improve clinical presentation and result in nonsignificant improvement in cause-specific, biochemical progression-free, and overall survival in the largest clinical study to date to address this issue.

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