Abstract
Objectives
To assess whether statin use improves local control (LC) in patients undergoing organ-preserving
trimodality therapy for muscle-invasive bladder cancer.
Methods
We retrospectively analyzed the data from 286 patients with muscle-invasive, transitional
cell carcinoma of the bladder treated with maximal transurethral resection of the
bladder tumor followed by chemoradiotherapy from 1986 to 2003 at the Massachusetts
General Hospital. Patients with a complete response after induction chemoradiotherapy
received consolidation chemoradiotherapy and those with an incomplete response underwent
cystectomy. Of the 286 patients, 35 (12%) were known to be taking a statin during
chemoradiotherapy. LC was defined as freedom from the development of muscle-invasive
bladder cancer or superficial bladder cancer necessitating cystectomy.
Results
The median follow-up time was 2.7 years for all patients and 3.1 years for survivors.
The overall 5-year LC rate was 55%. On univariate analysis, tumor stage, completeness
of transurethral resection of the bladder tumor, hydronephrosis, chemotherapy type,
treatment era, and statin use were significantly associated with LC. The 5-year LC
rate for patients taking a statin was 73% versus 52% for patients not taking a statin
(P = 0.04). On multivariate analysis incorporating covariates that were statistically
significant (P <0.05) on univariate analysis, only chemotherapy with cisplatin (P = 0.02) and the absence of hydronephrosis (P = 0.01) remained significantly associated with LC.
Conclusions
Statin use was associated with an improvement in LC on univariate analysis but was
not found to be independently associated with LC after controlling for known prognostic
factors. The potential beneficial interaction between statin use and chemoradiotherapy
in bladder cancer warrants further investigation in a prospective study.
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Article info
Publication history
Published online: December 04, 2006
Accepted:
August 17,
2006
Received:
April 19,
2006
Identification
Copyright
© 2006 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
