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Minerva Urologica e Nefrologica 2017 October;69(5):501-8

DOI: 10.23736/S0393-2249.17.02788-6

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Statin utilization improves oncologic and survival outcomes in patients with dyslipidemia and surgically treated renal cell carcinoma

Sean W. BERQUIST 1, Hak J. LEE 1, Zachary HAMILTON 1, Aditya BAGRODIA 2, Abd-elrahman HASSAN 1, Alp T. BEKSAÇ 1, Catherine A. DUFOUR 1, Song WANG 1, Reza MEHRAZIN 3, Anthony PATTERSON 3, Ithaar H. DERWEESH 1

1 Department of Urology, UC San Diego Health System, La Jolla, CA, USA; 2 Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA; 3 Department of Urology, University of Tennessee Health Science Center, Memphis, TN, USA


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BACKGROUND: We evaluated the role of statins in patients who underwent surgery for renal cell carcinoma (RCC) and who had dyslipidemia, as use of statins has been suggested to improve outcomes in RCC.
METHODS: Two-center retrospective study of patients with dyslipidemia who underwent surgery for RCC from 7/1995 to 6/2005. Patients were managed by statins or ezetimibe, fibrate agents, or cholestyramine. Analysis was conducted between patients who received statin therapy versus those that did not. Primary outcome was progression-free survival (PFS). Secondary outcomes were cancer-specific (CSS) and overall survival (OS). Multivariable analysis was performed to identify risk factors associated with disease progression.
RESULTS: In this study 283 patients were analyzed (180 statin, 103 non-statin, median follow-up 68 months). There were no significant demographic differences. Median duration of antidyslipidemia therapy was similar (statin 31 months vs. non-statin 28 months, P=0.413). Tumor size (statin 5.4 cm vs. non-statin 5.6 cm, P=0.569), stage distribution (P=0.591), histology (P=0.801), and grade (P=0.807) were similar. Kaplan-Meier analysis demonstrated higher 5-yr PFS (91% vs. 70%, P<0.001), CSS (88% vs. 69%, P<0.001), and OS (71% vs. 67%, P=0.025) in statin vs. non-statin patients. Multivariable analysis for factors associated with disease progression found absence of statin therapy (OR 2.41, P<0.001), higher stage (OR 2.01-3.86 P<0.001), and higher grade tumors (OR 2.07, P=0.006) to be predictive.
CONCLUSIONS: In RCC patients with dyslipidemia, statin use was associated with improved survival outcomes, and was an independent predictor of PFS. Further investigations are requisite to determine utility of statins in RCC patients.


KEY WORDS: Carcinoma, renal cell - Dyslipidemias - Survival - Disease-free survival

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