Influence of serum cholesterol level and statin treatment on prostate cancer aggressiveness
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Thomas J. Schnoeller1, Florian Jentzmik1,2, Andres J. Schrader3 and Julie Steinestel3
1Department of Urology, Ulm University Medical Center, Ulm, Germany
2Department of Urology, St. Elisabeth Hospital, Ravensburg, Germany
3Department of Urology, Muenster University Medical Center, Muenster, Germany
Julie Steinestel, email: [email protected]
Keywords: prostate cancer, tumor biology, biomarker, cholesterol, statin therapy
Received: February 13, 2017 Accepted: March 14, 2017 Published: April 07, 2017
Both cholesterol levels and the use of statins have been described to influence the development and prognosis of prostate cancer (PC). In this retrospective, cross-sectional analysis of consecutive cases from a tertiary referral center we evaluated an association between hypercholesterolemia (≥5.0mmol/l), the use of statins, and advanced/aggressive PC in 767 men with histologically confirmed, clinically localized PC awaiting radical prostatectomy. We found that patients with HCE (n=287, 37.4%) had a significantly higher incidence of poorly differentiated PC (Gleason score ≥7b, 81.1% vs. 4.9%), advanced local tumor stage (≥pT3, 57.7% vs. 22.2%), and nodal involvement (19.8% vs. 1.6%). Multivariate logistic regression analysis identified hypercholesterolemia as a risk factor for aggressive and/or advanced PC (OR 2.01, p<0.001) whereas statin intake showed an odds ratio of 0.49 (p=0.005) indicating a negative association with high-risk PC. Despite a limited number of patients using statins (~9.5%), adjusted and weighed multivariate logistic regression models revealed that preoperative hypercholesterolemia is associated with a diagnosis of high-risk PC which is negatively influenced by statin intake.
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