Serum Lipid Profile and Risk of Prostate Cancer Recurrence: Results from the SEARCH Database

Abstract

Background: Evidence for an association between total cholesterol, low-and high-density lipoproteins (LDL and HDL, respectively), triglycerides, and prostate cancer is conflicting. Given that prostate cancer and dyslipidemia affect large proportions of Western society, understanding these associations has public health importance.Methods: We conducted a retrospective cohort analysis of 843 radical prostatectomy (RP) patients who never used statins before surgery within the Shared Equal Access Regional Cancer Hospital (SEARCH) database. Multivariable Cox proportional hazards analysis was used to investigate the association between cholesterol, LDL, HDL, and triglycerides and biochemical recurrence risk. In secondary analysis, we explored these associations in patients with dyslipidemia, defined using National Cholesterol Education Program guidelines.Results: Elevated serum triglycerides were associated with increased risk of prostate cancer recurrence [HR per 10 mg/dl , 1.03; 95% confidence interval (CI), 1.01-1.05] but associations between total cholesterol, LDL and HDL, and recurrence risk were null. However, among men with dyslipidemia, each 10 mg/dl increase in cholesterol and HDL was associated with 9% increased recurrence risk (HR, 1.09; 95% CI, 1.01-1.17) and 39% reduced recurrence risk (HR, 0.61; 95% CI, 0.41-0.91), respectively.Conclusions: Elevated serum triglycerides were associated with increased risk of prostate cancer recurrence. Cholesterol, LDL, or HDL were not associated with recurrence risk among all men. However, among men with dyslipidemia, elevated cholesterol and HDL levels were associated with increased and decreased risk of recurrence, respectively.Impact: These findings, coupled with evidence that statin use is associated with reduced recurrence risk, suggest that lipid levels should be explored as a modifiable risk factor for prostate cancer recurrence. Cancer Epidemiol Biomarkers Prev; 23(11); 2349-56. Ó2014 AACR.

Cholesterol Enhances Colorectal Cancer Progression via ROS Elevation and MAPK Signaling Pathway Activation

“…A substantial body of evidence supports an association between obesity and various cancers, including CRC [19]. Elevated serum cholesterol levels were shown to be linked to a higher risk of developing certain cancers, and higher cholesterol levels may also increase cancer recurrence [20, 21]. Moreover, statins use in patients with cancer is associated with a reduced cancer-related mortality [22].…”

Racial Differences in the Association Between Preoperative Serum Cholesterol and Prostate Cancer Recurrence: Results from the SEARCH Database

“…Previously in this cohort, we reported that elevated triglycerides were associated with increased risk of prostate cancer recurrence among all men, while high cholesterol, high low-density lipoprotein (LDL) and low high-density lipoprotein (HDL) were associated with increased risk of recurrence only among men with dyslipidemia [17]. However, due to limited numbers of patients in our prior study, we were unable to test whether associations differed between black and non-black men.…”

“…The SEARCH database is a retrospective cohort of prostate cancer patients undergoing radical prostatectomy at six Veterans Administration (VA) Medical Centers (West Los Angeles, CA; Palo Alto, CA; San Diego, CA; Durham, NC; Asheville, NC; and Augusta, GA) [17]. Institutional Review Board approval was obtained to abstract and analyze the data.…”

Targeting intratumoral androgens: statins and beyond

“…PSA relapse) following prostatectomy in 843 patients who had never received statins prior to their surgery. They found that elevated triglycerides were associated with increased risk of recurrence for the entire cohort, and that an elevated total cholesterol level was associated with an increased risk for those with hyperlipidemia [Allott et al 2014]. While this finding is consistent with statins exerting a beneficial antitumor effect through lowering lipids, it does not specifically address whether or not statins modulate SLCO transporter activity.…”

“…Several epidemiologic and retrospective studies have been completed to specifically evaluate for an association between statin use and the development of prostate cancer [Flick et al 2007;Boudreau et al 2008;Chang et al 2011;Allott et al 2014;Jespersen et al 2014;Chan et al 2015;Cuaron et al 2015;Kantor et al 2015;Luo et al 2015;Sun et al 2015;Zapata et al 2015]. In general, these studies have supported the notion that statins may function as a prostate cancer chemoprotective agent; however, some data conflict with this assertion.…”