BACKGROUND: We aimed to test the hypothesis that the immune-modulatory effect of statins may improve survival outcomes in patients with non-muscle invasive bladder cancer (NMIBC). We focused on a cohort of patients diagnosed with high risk NMIBC, that were treated with intravesical BCG immunotherapy.METHODS: We included patients at first diagnosis of T1 high grade NMIBC after transurethral resection of bladder (TURB). All procedures were performed at 18 different tertiary institutions between January 2002 and December 2012. Univariable and multivariable models were used to test differences in terms of residual tumor, disease recurrence, disease progression and overall mortality (OM) rates.RESULTS: Overall, 1510 patients with T1 high grade NMIBC at TURB were included in our analyses. Of these, 402 (26.6%) were statin users. At multivariable analysis, statin use was associated with a higher rate of high-grade BC at reTURB (OR: 1.37, 95%CI: 1.04-1.78; P=0.022), while at follow-up it was not independently associated with OM (HR: 0.71, 95%CI: 0.50-1.03; P=0.068) and disease progression rates (HR: 0.97, 95%CI: 0.79-1.19; P=0.753). Conversely, statin use has been shown to be independently associated with a lower risk of recurrence (HR:0.80, 95%CI: 0.67-0.95; P=0.009). The median recurrence-free survival was 47 (95%CI 40-49) months for those classified as non-statin users vs. 53 (95%CI 48-68) months in those classified as statin users.CONCLUSIONS: Statin daily intake do not compromise oncological outcomes in high risk NMIBC patients treated with BCG. Moreover, statin may have a beneficial effect on recurrence rates in this cohort of patients.

Association of statin use and oncological outcomes in patients with first diagnosis of T1 high grade non-muscle invasive urothelial bladder cancer: results from a multicenter study / Ferro, Matteo; Marchioni, Michele; Lucarelli, Giuseppe; Vartolomei, Mihai D; Soria, Francesco; Terracciano, Daniela; Mistretta, Francesco A; Luzzago, Stefano; Buonerba, Carlo; Cantiello, Francesco; Mari, Andrea; Minervini, Andrea; Veccia, Alessandro; Antonelli, Alessandro; Musi, Gennaro; Hurle, Rodolfo; Busetto, Gian M; Del Giudice, Francesco; Chung, Benjamin I; Berardinelli, Francesco; Perdonà, Sisto; Del Prete, Paola; Mirone, Vincenzo; Borghesi, Marco; Porreca, Angelo; Bove, Pierluigi; Autorino, Riccardo; Crisan, Nicolae; Abu Farhan, Abdal R; Battaglia, Michele; Ditonno, Pasquale; Russo, Giorgio I; Muto, Matteo; Damiano, Rocco; Manfredi, Matteo; Porpiglia, Francesco; DE Cobelli, Ottavio; Schips, Luigi. - In: MINERVA UROLOGY AND NEPHROLOGY. - ISSN 2724-6051. - ELETTRONICO. - 73:(2021), pp. 796-802. [10.23736/S2724-6051.20.04076-X]

Association of statin use and oncological outcomes in patients with first diagnosis of T1 high grade non-muscle invasive urothelial bladder cancer: results from a multicenter study

Lucarelli, Giuseppe;Mari, Andrea;Minervini, Andrea;
2021

Abstract

BACKGROUND: We aimed to test the hypothesis that the immune-modulatory effect of statins may improve survival outcomes in patients with non-muscle invasive bladder cancer (NMIBC). We focused on a cohort of patients diagnosed with high risk NMIBC, that were treated with intravesical BCG immunotherapy.METHODS: We included patients at first diagnosis of T1 high grade NMIBC after transurethral resection of bladder (TURB). All procedures were performed at 18 different tertiary institutions between January 2002 and December 2012. Univariable and multivariable models were used to test differences in terms of residual tumor, disease recurrence, disease progression and overall mortality (OM) rates.RESULTS: Overall, 1510 patients with T1 high grade NMIBC at TURB were included in our analyses. Of these, 402 (26.6%) were statin users. At multivariable analysis, statin use was associated with a higher rate of high-grade BC at reTURB (OR: 1.37, 95%CI: 1.04-1.78; P=0.022), while at follow-up it was not independently associated with OM (HR: 0.71, 95%CI: 0.50-1.03; P=0.068) and disease progression rates (HR: 0.97, 95%CI: 0.79-1.19; P=0.753). Conversely, statin use has been shown to be independently associated with a lower risk of recurrence (HR:0.80, 95%CI: 0.67-0.95; P=0.009). The median recurrence-free survival was 47 (95%CI 40-49) months for those classified as non-statin users vs. 53 (95%CI 48-68) months in those classified as statin users.CONCLUSIONS: Statin daily intake do not compromise oncological outcomes in high risk NMIBC patients treated with BCG. Moreover, statin may have a beneficial effect on recurrence rates in this cohort of patients.
73
796
802
Ferro, Matteo; Marchioni, Michele; Lucarelli, Giuseppe; Vartolomei, Mihai D; Soria, Francesco; Terracciano, Daniela; Mistretta, Francesco A; Luzzago, Stefano; Buonerba, Carlo; Cantiello, Francesco; Mari, Andrea; Minervini, Andrea; Veccia, Alessandro; Antonelli, Alessandro; Musi, Gennaro; Hurle, Rodolfo; Busetto, Gian M; Del Giudice, Francesco; Chung, Benjamin I; Berardinelli, Francesco; Perdonà, Sisto; Del Prete, Paola; Mirone, Vincenzo; Borghesi, Marco; Porreca, Angelo; Bove, Pierluigi; Autorino, Riccardo; Crisan, Nicolae; Abu Farhan, Abdal R; Battaglia, Michele; Ditonno, Pasquale; Russo, Giorgio I; Muto, Matteo; Damiano, Rocco; Manfredi, Matteo; Porpiglia, Francesco; DE Cobelli, Ottavio; Schips, Luigi
File in questo prodotto:
File Dimensione Formato  
statin.pdf

Accesso chiuso

Tipologia: Pdf editoriale (Version of record)
Licenza: DRM non definito
Dimensione 412.06 kB
Formato Adobe PDF
412.06 kB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in FLORE sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2158/1287818
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 2
  • ???jsp.display-item.citation.isi??? 2
social impact