非肌层性膀胱癌患者同步他汀药物治疗的潜在益处

The potential benefits of concomitant statins treatment in patients with non-muscle-invasive bladder cancer

BJU INTERNATIONAL

影响因子:4.4

分区:医学2区 / 泌尿学与肾脏学2区

发表日期:2025 Jan

作者: 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

DOI: 10.1111/bju.16493

keywords: cancer‐specific survival; non‐muscle‐invasive bladder cancer; overall survival; progression‐free survival; recurrence‐free survival; statins

摘要

本研究旨在探讨他汀类药物对接受辅助膀胱内卡介苗（BCG）免疫治疗的非肌层性膀胱癌（NMIBC）患者生存结局的影响。通过回顾性分析2001年至2020年接受膀胱内BCG治疗且有他汀类药物处方的连续患者队列，比较他汀组与非他汀组的总生存（OS）、癌症特异性生存（CSS）、无复发生存（RFS）和无进展生存（PFS）。共纳入2602例NMIBC患者，随访中位数为11.0年。Kaplan-Meier分析显示，他汀组的OS（P<0.001）、CSS（P<0.001）和PFS（P<0.001）均显著优于非他汀组。亚组分析表明，B波治疗前开始使用他汀药物的患者在CSS（P=0.02）和PFS（P<0.01）方面表现更佳。多变量Cox回归分析显示，“B波前使用他汀”组为OS（HR 0.607，95% CI 0.514-0.716）和CSS（HR 0.571，95% CI 0.376-0.868）的独立保护因素，但对RFS（HR 0.885，95% CI 0.736-1.065）和PFS（HR 0.689，95% CI 0.469-1.013）无显著影响。结论认为，他汀治疗对接受膀胱内BCG的NMIBC患者的OS和CSS具有保护作用。

Abstract

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.