Statin use and risk of prostate cancer biochemical recurrence after radical prostatectomy

• Use of statin therapy in patients with prostate cancer. • Statins use associated with improved biochemical free survival in patients with radical prostatectomy. • Statin therapy may have benefits beyond known cardiovascular benefits. Multiple studies have investigated the role of statins in prostate cancer (CaP), the leading cause of cancer related death in men. Retrospective cohort studies investigating the correlation between statin use and biochemical recurrence free (BCRF) survival in men with CaP have been inconclusive. In the largest reported surgical cohort to date, we investigated the effect of statin therapy on BCRF and overall survival in patients with CaP who have undergone radical prostatectomy (RP). We performed a retrospective analysis of men ( n = 3,088) participating in the NCI funded Specialized Program of Research Excellence (SPORE) in CaP at Northwestern University (NM) in Chicago, Illinois. Patients were treated with RP between 2002 and 2015. Patients in the statin users group received treatment within 2 years prior to or subsequent to RP. Wilcoxon rank-sum and Fisher's exact tests were used to compare age, race, Gleason score, clinical staging, and pathological stage between statin users and nonstatin users. The analysis identified 1,222 statin users and 1,865 nonusers (mean age 71 years, 92% Caucasian). After a median follow-up time of 49.0 months, the 5-year BCRF survival rate was 93.3% (95% confidence interval [CI]: 91.9–94.8%) among statin users and 88.6% (95% CI: 87.1%–90%) among nonusers (log-rank P < 0.001). After 10 years, the progression-free survival (PFS) was 91.7% (95% CI: 90.1%–93.3%) among statin users and 86.5% (95% CI: 84.4%–88.2%) among nonusers (log-rank P < 0.001). Extended follow-up data in this large surgical cohort show statin use improves BCRF but not overall survival in RP patients.