Statin Use and Serum Lipid Levels Are Associated with Survival Outcomes after Surgery for Renal Cell Carcinoma

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Abstract

Objective To evaluate the association of statin use and preoperative serum lipid parameters with oncologic outcomes following surgery for renal cell carcinoma. Methods A total of 850 patients who underwent surgery for localized renal cell carcinoma at our institution from 2000 to 2012 were included. Use of statins, preoperative serum lipid profile, and comprehensive clinicopathologic features were retrospectively recorded. Kaplan-Meier analysis and multivariate Cox proportional hazards model were employed to compare survival outcomes. Results There were 342 statin users and 508 non-users. Median follow-up was 25.0 months. Statin users were older, had greater body mass index, and had worse performance status than non-users. Tumor pathologic characteristics were balanced between groups. Five-year recurrence free survival (RFS) was 77.9% for non-users compared with 87.6% for statin users (P =.004). After adjustment for clinicopathologic variables, statin use was independently associated with improved RFS (hazard ratio [HR] 0.54, 95% confidence interval [CI] 0.33-0.86, P =.011) and overall survival (HR 0.45, 95%CI 0.28-0.71, P =.001). In patients with available serum lipid parameters (n = 193), 5-year RFS was 83.8% for patients with triglycerides 250 mg/dL (P 250 mg/dL) was independently associated with worse RFS (HR 2.69, 95%CI 1.22-5.93, P =.015) on multivariate analysis. Conclusion Statin use was independently associated with improved survival, whereas elevated serum triglyceride levels correlated with worse oncologic outcomes in this cohort. These findings warrant validation in prospective studies.

Original languageEnglish (US)
Pages (from-to)1146-1152
Number of pages7
JournalUrology
Volume86
Issue number6
DOIs
StatePublished - Dec 1 2015

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Renal Cell Carcinoma
Lipids
Survival
Serum
Recurrence
Confidence Intervals
Triglycerides
Kaplan-Meier Estimate
Proportional Hazards Models
Body Mass Index
Multivariate Analysis
Prospective Studies

ASJC Scopus subject areas

  • Urology

Cite this

@article{018e49c4b32d44e680806d111c85bb27,
title = "Statin Use and Serum Lipid Levels Are Associated with Survival Outcomes after Surgery for Renal Cell Carcinoma",
abstract = "Objective To evaluate the association of statin use and preoperative serum lipid parameters with oncologic outcomes following surgery for renal cell carcinoma. Methods A total of 850 patients who underwent surgery for localized renal cell carcinoma at our institution from 2000 to 2012 were included. Use of statins, preoperative serum lipid profile, and comprehensive clinicopathologic features were retrospectively recorded. Kaplan-Meier analysis and multivariate Cox proportional hazards model were employed to compare survival outcomes. Results There were 342 statin users and 508 non-users. Median follow-up was 25.0 months. Statin users were older, had greater body mass index, and had worse performance status than non-users. Tumor pathologic characteristics were balanced between groups. Five-year recurrence free survival (RFS) was 77.9{\%} for non-users compared with 87.6{\%} for statin users (P =.004). After adjustment for clinicopathologic variables, statin use was independently associated with improved RFS (hazard ratio [HR] 0.54, 95{\%} confidence interval [CI] 0.33-0.86, P =.011) and overall survival (HR 0.45, 95{\%}CI 0.28-0.71, P =.001). In patients with available serum lipid parameters (n = 193), 5-year RFS was 83.8{\%} for patients with triglycerides 250 mg/dL (P 250 mg/dL) was independently associated with worse RFS (HR 2.69, 95{\%}CI 1.22-5.93, P =.015) on multivariate analysis. Conclusion Statin use was independently associated with improved survival, whereas elevated serum triglyceride levels correlated with worse oncologic outcomes in this cohort. These findings warrant validation in prospective studies.",
author = "Haddad, {Ahmed Q.} and Lai Jiang and Cadeddu, {Jeffrey A} and Yair Lotan and Jeffrey Gahan and Hynan, {Linda S} and Neil Gupta and Ganesh Raj and Sagalowsky, {Arthur I} and Vitaly Margulis",
year = "2015",
month = "12",
day = "1",
doi = "10.1016/j.urology.2015.09.015",
language = "English (US)",
volume = "86",
pages = "1146--1152",
journal = "Urology",
issn = "0090-4295",
publisher = "Elsevier Inc.",
number = "6",

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TY - JOUR

T1 - Statin Use and Serum Lipid Levels Are Associated with Survival Outcomes after Surgery for Renal Cell Carcinoma

AU - Haddad, Ahmed Q.

AU - Jiang, Lai

AU - Cadeddu, Jeffrey A

AU - Lotan, Yair

AU - Gahan, Jeffrey

AU - Hynan, Linda S

AU - Gupta, Neil

AU - Raj, Ganesh

AU - Sagalowsky, Arthur I

AU - Margulis, Vitaly

PY - 2015/12/1

Y1 - 2015/12/1

N2 - Objective To evaluate the association of statin use and preoperative serum lipid parameters with oncologic outcomes following surgery for renal cell carcinoma. Methods A total of 850 patients who underwent surgery for localized renal cell carcinoma at our institution from 2000 to 2012 were included. Use of statins, preoperative serum lipid profile, and comprehensive clinicopathologic features were retrospectively recorded. Kaplan-Meier analysis and multivariate Cox proportional hazards model were employed to compare survival outcomes. Results There were 342 statin users and 508 non-users. Median follow-up was 25.0 months. Statin users were older, had greater body mass index, and had worse performance status than non-users. Tumor pathologic characteristics were balanced between groups. Five-year recurrence free survival (RFS) was 77.9% for non-users compared with 87.6% for statin users (P =.004). After adjustment for clinicopathologic variables, statin use was independently associated with improved RFS (hazard ratio [HR] 0.54, 95% confidence interval [CI] 0.33-0.86, P =.011) and overall survival (HR 0.45, 95%CI 0.28-0.71, P =.001). In patients with available serum lipid parameters (n = 193), 5-year RFS was 83.8% for patients with triglycerides 250 mg/dL (P 250 mg/dL) was independently associated with worse RFS (HR 2.69, 95%CI 1.22-5.93, P =.015) on multivariate analysis. Conclusion Statin use was independently associated with improved survival, whereas elevated serum triglyceride levels correlated with worse oncologic outcomes in this cohort. These findings warrant validation in prospective studies.

AB - Objective To evaluate the association of statin use and preoperative serum lipid parameters with oncologic outcomes following surgery for renal cell carcinoma. Methods A total of 850 patients who underwent surgery for localized renal cell carcinoma at our institution from 2000 to 2012 were included. Use of statins, preoperative serum lipid profile, and comprehensive clinicopathologic features were retrospectively recorded. Kaplan-Meier analysis and multivariate Cox proportional hazards model were employed to compare survival outcomes. Results There were 342 statin users and 508 non-users. Median follow-up was 25.0 months. Statin users were older, had greater body mass index, and had worse performance status than non-users. Tumor pathologic characteristics were balanced between groups. Five-year recurrence free survival (RFS) was 77.9% for non-users compared with 87.6% for statin users (P =.004). After adjustment for clinicopathologic variables, statin use was independently associated with improved RFS (hazard ratio [HR] 0.54, 95% confidence interval [CI] 0.33-0.86, P =.011) and overall survival (HR 0.45, 95%CI 0.28-0.71, P =.001). In patients with available serum lipid parameters (n = 193), 5-year RFS was 83.8% for patients with triglycerides 250 mg/dL (P 250 mg/dL) was independently associated with worse RFS (HR 2.69, 95%CI 1.22-5.93, P =.015) on multivariate analysis. Conclusion Statin use was independently associated with improved survival, whereas elevated serum triglyceride levels correlated with worse oncologic outcomes in this cohort. These findings warrant validation in prospective studies.

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U2 - 10.1016/j.urology.2015.09.015

DO - 10.1016/j.urology.2015.09.015

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VL - 86

SP - 1146

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JO - Urology

JF - Urology

SN - 0090-4295

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