Statin and metformin therapy in prostate cancer patients with hyperlipidemia who underwent radiotherapy: a population-based cohort study
Authors Li K, Si-Tu J, Qiu J, Lu L, Mao Y, Zeng H, Chen M, Lai C, Chang HJ, Wang D
Received 26 February 2018
Accepted for publication 27 December 2018
Published 4 February 2019 Volume 2019:11 Pages 1189—1197
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Amy Norman
Peer reviewer comments 4
Editor who approved publication: Dr Antonella D'Anneo
Ke Li,1,* Jie Si-Tu,1,* Jianguang Qiu,2,* Li Lu,2,* Yunhua Mao,1 Hua Zeng,3 Mingkun Chen,4 Caiyong Lai,5 Heng-Jui Chang,6 Dejuan Wang2
1Department of Urology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province 510630, China; 2Department of Urology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province 510655, China; 3Department of Emergency, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province 510630, China; 4Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong Province 510630, China; 5Department of Urology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province 510632, China; 6Department of Radiation Therapy Oncology, Min-Sheng General Hospital, Taoyuan 330, Taiwan
*These authors contributed equally to this work
Purpose: To evaluate the association between the use of statins and/or metformin and patient survival in prostate cancer patients in Taiwan.
Subjects and methods: Newly diagnosed prostate cancer patients who had hyperlipidemia and received radiotherapy were identified from the National Health Insurance Research Database 2000–2010. The survival rate was estimated by the Kaplan–Meier method. Univariate and multivariate Cox regression analyses were performed to examine the association of mortality. Sensitivity analysis was performed to assess the risk of mortality in patients with diabetes.
Results: The study included 567 patients. Patients who used statins or metformin after prostate cancer diagnosis had longer average survival times (9.3 years and 8.1 years, respectively; P=0.001) compared with patients who persistently used or used the medicines prior to cancer diagnosis. Multivariate Cox regression analysis found that patients treated with statins after cancer diagnosis were significantly associated with a lower risk of mortality (aHR =0.24, 95% CI =0.09–0.66) compared to patients who did not use statins during the study period. Patients treated with metformin after cancer diagnosis were significantly associated more with an increased risk of mortality (aHR =6.78, 95% CI =2.45–18.77) compared to patients who did not use metformin during the study period. Sensitivity analysis revealed that the average survival time was similar among different medicine use groups in patients with diabetes.
Conclusion: The finding suggests that statins and metformin use after prostate cancer diagnosis may increase survival in patients with hyperlipidemia and radiotherapy.
Keywords: prostate cancer, metformin, statin, hyperlipidemia, mortality, survival
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