Influence of serum cholesterol level and statin treatment on prostate cancer aggressiveness

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// Thomas J. Schnoeller 1 , Florian Jentzmik 1, 2 , Andres J. Schrader 3 and Julie Steinestel 3 1 Department of Urology, Ulm University Medical Center, Ulm, Germany 2 Department of Urology, St. Elisabeth Hospital, Ravensburg, Germany 3 Department of Urology, Muenster University Medical Center, Muenster, Germany Correspondence to: Julie Steinestel, email: Julie.steinestel@ukmuenster.com Keywords: prostate cancer, tumor biology, biomarker, cholesterol, statin therapy Received: February 13, 2017 Accepted: March 14, 2017 Published: April 07, 2017 ABSTRACT 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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