Evidence map›Paper›PMID 30528885›Full record

Observational studyUrologic oncology2019

The impact of statins in combination with androgen deprivation therapyin patients with advanced prostate cancer: A large observational study.

India Anderson-Carter, Natasza Posielski, Jinn-Ing Liou, Tariq A Khemees, Tracy M Downs, E Jason Abel, David F Jarrard, Kyle A Richards

Open access · greenAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Urologic oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 5 pooled it
1.3field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 5 syntheses or guidelines pooled it, 37 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Trial
  7. Trial
  8. Article
  9. Article
  10. Article
  11. Review
  12. Review
  13. Review
  14. Article
  15. Statins in risk-reduction and treatment of cancer.World journal of clinical oncology · 2020
    Review
  16. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

India Anderson-CarterThe University of Wisconsin-Madison, Department of Urology, Madison, WI.
Natasza PosielskiThe University of Wisconsin-Madison, Department of Urology, Madison, WI.
Jinn-Ing LiouThe University of Wisconsin-Madison, Department of Medicine, Madison, WI.
Tariq A KhemeesThe University of Wisconsin-Madison, Department of Urology, Madison, WI.
Tracy M DownsThe University of Wisconsin-Madison, Department of Urology, Madison, WI.
E Jason AbelThe University of Wisconsin-Madison, Department of Urology, Madison, WI.
David F JarrardThe University of Wisconsin-Madison, Department of Urology, Madison, WI.
Kyle A RichardsThe University of Wisconsin-Madison, Department of Urology, Madison, WI; William S. Middleton Memorial Veterans Hospital, Department of Surgery, Section of Urology, Madison, WI. Electronic address: richardsk@urology.wisc.edu.
University of Wisconsin–Madison · US

Funding

Surgery Summer Research Experience for Medical StudentsT35DK062709 · NIDDK · UNIVERSITY OF WISCONSIN-MADISON · PI MEZRICH, JOSHUA D · 2006 to 2023
$870k
NIDDK NIH HHS T35 DK062709
6 · The paper itself

Abstract

backgroundStatins are thought to possess antineoplastic properties related to their effect on cell proliferation and steroidogenesis. Progression to castrate resistant prostate cancer (CaP) includes de-regulation of androgen synthesis suggesting a role for statins in this setting. Our goal was to assess the role of statin use on oncologic outcomes in patients with advanced CaP being treated with androgen deprivation therapy (ADT).

methodsThe national VA database was used to identify all men diagnosed with CaP who were treated with ADT for at least 6 months between 2000 and 2008 with follow-up through May 2016. Our cohort was stratified based on statin use of at least 6 months duration during the same time. Multivariable Cox proportional hazards analyses with inverse propensity score weighted (IPSW) adjustment were calculated to assess for primary outcomes of CaP-specific survival (CSS), overall survival (OS) and skeletal related events (SREs).

resultsA total of 87,346 patients on ADT were included in the study cohort, 53,360 patients used statins and 33,986 did not. Statin users were younger in age (median 73 vs. 76, P < 0.001), more likely to have a higher Charlson comorbidity index (CCI) >3 (3.1% vs. 2.5%, P < 0.001) and more likely to have a high grade (Gleason score 8-10) cancer (12.3% vs. 10.9%, P < 0.001). Statin users had longer OS (median 6.5 vs. 4.0 years P < 0.001) and decreased death from CaP (5-year CSS 94.0% vs. 87.3%, P < 0.001). Statin use was also associated with longer time to a SRE (median 5.9 vs. 3.7 years, P < 0.001). On multivariable Cox proportional hazards analysis with inverse propensity score weighted, statin use was an independent predictor of improved OS (hazard ratio [HR] 0.66, confidence interval [CI] 0.63-0.68; P < 0.001), CSS (HR 0.56, 95% CI 0.53-0.60; P < 0.001), and SREs (HR 0.64, 95%CI 0.59-0.71; P < 0.001) when controlling for age, race, Charlson comorbidity index, prostate-specific antigen, and Gleason score.

conclusionThe use of statins in men on ADT for CaP is associated with improved CSS and OS. Statins are inexpensive, well-tolerated medications that offer a promising adjunct to ADT, but require further prospective studies.

Indexed as

AgedAged, 80 and overAndrogen AntagonistsCohort StudiesDisease ProgressionDrug Therapy, CombinationFollow-Up StudiesHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMalePrognosisProstatic NeoplasmsSurvival RateAndrogen AntagonistsHydroxymethylglutaryl-CoA Reductase InhibitorsGonadotropin-releasing hormone/analogs and derivativesHospitalsHydroxymethylglutaryl-CoA reductase inhibitorsProstatic neoplasmsVeterans

Identifiers

PMID30528885
PMCPMC6919968
OpenAlexW2905502874

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.