To investigate the influence of statins on the survival outcomes of patients with non-muscle-invasive bladder cancer (NMIBC) treated with adjuvant intravesical bacille Calmette-Guérin (BCG) immunotherapy.
A retrospective cohort of consecutive patients with NMIBC who received intravesical BCG therapy from 2001 to 2020 and statins prescription were identified. Overall survival (OS), cancer-specific survival (CSS), recurrence-free survival (RFS), and progression-free survival (PFS) were analysed between the Statins Group vs No-Statins Group using Kaplan-Meier method and multivariable Cox regression.
A total of 2602 patients with NMIBC who received intravesical BCG were identified. The median follow-up was 11.0 years. On Kaplan-Meier analysis, the Statins Group had significant better OS (P < 0.001), CSS (P < 0.001), and PFS (P < 0.001). Subgroup analysis indicated statins treatment started before BCG treatment had better CSS (P = 0.02) and PFS (P < 0.01). Upon multivariable Cox regression analysis, the 'statins before BCG' group was an independent protective factor for OS (hazard ratio [HR] 0.607, 95% confidence interval [CI] 0.514-0.716), and CSS (HR 0.571, 95% CI 0.376-0.868), but not RFS (HR 0.885, 95% CI 0.736-1.065), and PFS (HR 0.689, 95% CI 0.469-1.013).
Statins treatment appears to offer protective effects on OS and CSS for patients with NMIBC receiving adjuvant intravesical BCG.
BJU international. 2024 Sep 10 [Epub ahead of print]
Kang Liu, Rossella Nicoletti, Hongda Zhao, Xuan Chen, Peter Ka-Fung Chiu, Chi-Fai Ng, Renate Pichler, Laura S Mertens, Takafumi Yanagisawa, Luca Afferi, Andrea Mari, Satoshi Katayama, Juan Gomez Rivas, Riccardo Campi, Maria Carmen Mir, Michael Rink, Yair Lotan, Morgan Rouprêt, Shahrokh F Shariat, Jeremy Yuen-Chun Teoh
S.H. Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China., Department of Urology, Medical University of Innsbruck, Innsbruck, Austria., Department of Surgical Oncology (Urology), Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands., Department of Urology, Medical University of Vienna, Vienna, Austria., Department of Urology, Luzerner Kantonsspital, Lucerne, Switzerland., Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy., Department of Urology, Hospital Clinico San Carlos, Madrid, Spain., Department of Urology, Hospital Universitario La Ribera, Valencia, Spain., Department of Urology, Marienkrankenhaus Hamburg gGmbH, Hamburg, Germany., Department of Urology, University of Texas Southwestern, Dallas, TX, USA., Department of Urology, GRC 5 Predictive Onco-Urology, AP-HP, Hôpital Pitié-Salpêtrière, Sorbonne Université, Paris, France.