WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Statins have shown 
broad spectrum anti-cancer properties in laboratory studies. In epidemiological 
studies, use of statins has been associated with reduced risk of advanced 
prostate cancer. However, the effects of statins on prostate cancer disease 
progression following curative treatment have not been extensively studied, and 
previous studies reported conflicting results. This study found no clear 
association between overall statin use and risk of disease progression, as well 
as lack of a monotone dose-response relationship between the use of statins, 
whether it was use before or after prostatectomy, and prostate cancer disease 
progression.
OBJECTIVE: To investigate whether use of HMG-CoA reductase inhibitors 
('statins'), which have shown broad spectrum anti-cancer properties in 
laboratory studies, is associated with a reduced risk of recurrence in patients 
with prostate cancer who undergo radical prostatectomy.
PATIENTS AND METHODS: All men with incident prostate cancer diagnosed between 
2004 and 2005 who subsequently underwent radical prostatectomy by the end of 
2005 in the Kaiser Permanente Southern California (KPSC) health plan were 
identified using KPSC's cancer registry. Subjects were followed for up to 5 
years after prostatectomy for (i) biochemical recurrence, defined as a single 
PSA measurement >0.2 ng/mL, and (ii) clinical disease progression, defined as 
diagnosis of metastatic disease or prostate-cancer-related death. Information on 
statin use, demographics, comorbidities, patho-clinical factors and outcomes 
were ascertained from KPSC's electronic medical records. The effects of statin 
use prior to and after prostatectomy were both examined using bivariate and 
multivariate Cox models, adjusting for known prognostic factors. For 
postoperative statin exposure, a time-dependent Cox model was used.
RESULTS: A total of 1200 men were included; 37% had preoperative and 56% had 
postoperative statin use. Neither preoperative nor postoperative statin use was 
associated with biochemical recurrence (hazard ratio [HR] = 1.00 [0.72-1.39] and 
1.05 [0.76-1.46], respectively) or clinical disease progression (HR = 0.63 
[0.31-1.27] and 1.20 [0.63-2.30], respectively). No clear dose-response 
relationship was found for duration of use.
CONCLUSIONS: Statin use may not prevent prostate cancer progression following 
radical prostatectomy. These findings do not provide support for the pursuit of 
a prospective clinical trial of statin use as a secondary prevention among 
surgically treated patients with prostate cancer.