Statin use linked to improved RCC surgery outcomes

By Shreeya Nanda, Senior medwireNews Reporter

Statin use at the time of surgery is associated with improved overall survival (OS) and disease-specific survival (DSS) in patients with renal cell carcinoma (RCC) of any stage, US researchers report.

Samuel Kaffenberger (Vanderbilt University Medical Center, Nashville, Tennessee) and colleagues reviewed outcomes for 270 patients who used statins and 646 participants who did not take statins at the time of undergoing radical or partial nephrectomy for RCC between 2000 and 2010 and were followed up for a median of 42.5 months.

Although 3-year OS did not differ significantly between statin users and nonusers, at 83.1% versus 77.3%, the difference in 3-year DSS was statistically significant, at 90.0% versus 83.5%.

The researchers found that higher American Society of Anesthesiologists class, higher pathological T stage, higher Fuhrman nuclear grade, presence of metastatic disease, node positivity, preoperative anaemia and corrected hypercalcaemia, and non-O blood type correlated with a decreased OS and DSS. Age was also significantly associated with a reduced OS.

Multivariable analysis, adjusting for these factors, in the 666 patients for whom complete data were available showed that statin users were significantly less likely to die from any cause than nonusers, with a hazard ratio of 0.62.

Statin use at time of surgery was also significantly associated with a 52% reduction in the risk of disease-specific mortality compared with nonuse.

Kaffenberger et al point out that their study is limited by the lack of information on duration and dosage of statin use in the included patients, but add that other studies suggest that “there is not a dose response for the protective effects of statins towards cancer.”

“While statin use has previously been identified to be associated with RCC incidence and also has been shown to be associated with RCC progression, statin use has not been previously identified as an independent predictor of survival in patients undergoing surgery for RCC”, writes the team in Urologic Oncology: Seminars and Original Investigations.

“Our work adds to the increasing volume of literature indicating a potential noncardiovascular cancer-specific survival benefit in patients on statins”, they conclude.

“In the future it will be important to assess in a prospective fashion whether this association translates into a survival benefit in patients undergoing surgery for RCC.”

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