The effect of statins on prostate cancer recurrence and mortality after definitive therapy: a systematic review and meta-analysis

In this work, we aim to further analyze the association of statins use with biochemical recurrence (BCR) of prostate cancer (PCa) and PCa-specific mortality after definitive therapy. A systematic literature search of PubMed, MEDLINE, and EMBASE through Jul 2015 was conducted. Pooled Hazard ratio (HR) estimates with corresponding 95% confidence intervals (CIs) were calculated using random effects model. STATA version 10 (Stata corporation, college station, TX) was employed to conduct all statistical analyses. A total of 22 and 8 studies contributed to the biochemical recurrence analysis and PCa-specific mortality, respectively. 13 trials were included for BCR-free survival analysis. The combined result showed statins users had lowered 12% BCR risk of PCa compared with non-users (HR = 0.88, 95% CI: 0.765-0.998) (p < 0.05). The association was null among the men who underwent radical prostatectomy as primary therapy (HR = 0.96, 95% CI: 0.83-1.09), while the improved outcomes had be seen among patients who received radiation therapy (HR = 0.67, 95% CI: 0.48-0.86). After excluding the patients undergoing ADT, participants did not benefit from statins use (HR = 0.94, 95% CI: 0.77-1.11). Meanwhile, long-term statins using did not alter recurrence risk. A lower risk of prostate cancer-specific mortality was observed among statins users (HR = 0.68, 95% CI: 0.56-0.80). There was a plausible trend towards increasing the BCR-free survival rate among statins users.