Statin use and mortality of patients with prostate cancer: a meta-analysis

OBJECTIVE: The aim of this meta-analysis was to investigate the effect of statin use on the mortality of patients with prostate cancer (PCa). METHODS: An electronic search of PubMed, Embase, and CENTRAL databases from inception to August 2015 was performed to find eligible studies. Articles investigating the association between statin use and mortality of PCa were identified. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using random- or fixed-effects models. RESULTS: In total, 13 studies that enrolled 100,536 participants were included in this meta-analysis. Results showed that prediagnostic statin use had a significantly lower risk of both all-cause mortality (ACM; HR, 0.56; 95% CI, 0.38–0.83) and PCa-specific mortality (PCSM; HR, 0.53; 95% CI, 0.36–0.77). Similarly, postdiagnostic statin use was correlated with reductions in both ACM (HR, 0.77; 95% CI, 0.69–0.87) and PCSM (HR, 0.64; 95% CI, 0.52–0.79). When stratified by primary treatment, postdiagnostic use of statins had a 0.4-fold lower risk of ACM in patients with PCa who were treated with local therapy; both pre- and postdiagnostic use of statins was correlated with a significantly lower risk of PCSM in patients who were treated with androgen deprivation therapy. CONCLUSION: Both pre- and postdiagnostic use of statins is associated with better overall survival and PCa-specific survival. This suggests a need for randomized controlled trials of statins in patients with PCa.