997 RISK FOR RECURRENT PROSTATE CANCER INCREASES WITH CHOLESTEROL ON A CONTINUUM IN MEN WITH ABNORMAL CHOLESTEROL LEVELS - AN UPDATE FROM THE SEACH DATABASE (2011)

You have accessJournal of UrologyProstate Cancer: Localized1 Apr 2011997 RISK FOR RECURRENT PROSTATE CANCER INCREASES WITH CHOLESTEROL ON A CONTINUUM IN MEN WITH ABNORMAL CHOLESTEROL LEVELS - AN UPDATE FROM THE SEACH DATABASE Lionel L. Bañez, Leah Gerber, William J. Aronson, Martha K. Terris, Joseph C. Presti, Christopher J. Kane, Christopher L. Amling, and Stephen J. Freedland Lionel L. BañezLionel L. Bañez Durham, NC More articles by this author , Leah GerberLeah Gerber Durham, NC More articles by this author , William J. AronsonWilliam J. Aronson Los Angeles, CA More articles by this author , Martha K. TerrisMartha K. Terris Augusta, GA More articles by this author , Joseph C. PrestiJoseph C. Presti Palo Alto, CA More articles by this author , Christopher J. KaneChristopher J. Kane San Diego, CA More articles by this author , Christopher L. AmlingChristopher L. Amling Portland, OR More articles by this author , and Stephen J. FreedlandStephen J. Freedland Durham, NC More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1030AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES There is mounting interest in elucidating the link between lipid dysregulation and prostate cancer (CaP) progression. Published data suggest that derangement of cholesterol (CHOL) levels may adversely impact recurrent CaP risk as well as long term outcomes. However, the relationship between serum CHOL and post-treatment biochemical recurrence (BCR) is not well-established. In 2008, we presented preliminary findings on 471 men from the Shared Equal Access Regional Cancer Hospital (SEARCH) database which suggested that elevated CHOL is associated with increased BCR risk. Herein, we present an updated analysis on a larger multi-racial cohort of veterans who underwent radical prostatectomy (RP). METHODS We identified 921 men from the (SEARCH) database who underwent RP from 1992 to 2007 and had available total CHOL, low-density lipoprotein (LDL), high-density lipoprotein (HDL) and triglycerides (TRIG) levels and known statin use status prior to RP. CHOL, LDL, HDL and TRIG were treated as continuous variables. We used proportional hazards regression to assess associations of cholesterol, LDL and HDL levels with BCR independent of age, race, PSA, year of surgery, body mass index, surgical center, biopsy Gleason sum, clinical stage, pathological Gleason sum, surgical margin status, extra-capsular extension, seminal vesicle invasion, lymph node involvement, prostate specimen weight and statin drug-use. Risk for BCR was assessed with lipid levels overall and as subsets wherein cases had deranged values specific to each lipid type (CHOL >200; LDL >100; HDL <40; TRIG >100 mg/dl). RESULTS For all-comers, pre-operative CHOL, LDL, HDL and TRIG levels, taken as continuous terms, were not associated with BCR risk (all p≥0.09) even after controlling for potential confounders, including intake of cholesterol-lowering drugs. However, when the analysis was restricted to men with CHOL >200 mg/dl, serum CHOL levels were significantly associated with increased BCR risk (log-transformed: HR 4.33; 95% CI 1.20–15.60; p=0.025). LDL, HDL and TRIG were not associated with BCR even when respective levels are deranged. CONCLUSIONS In this updated analysis wherein we nearly doubled our study sample size, CHOL levels increase the likelihood of post-RP BCR but only when total CHOL is abnormal. This finding suggests that the negative impact of lipid dysregulation becomes evident only after a threshold level is reached. If confirmed, these findings support investigating lipid control as a viable method of preventing CaP progression. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e402 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Lionel L. Bañez Durham, NC More articles by this author Leah Gerber Durham, NC More articles by this author William J. Aronson Los Angeles, CA More articles by this author Martha K. Terris Augusta, GA More articles by this author Joseph C. Presti Palo Alto, CA More articles by this author Christopher J. Kane San Diego, CA More articles by this author Christopher L. Amling Portland, OR More articles by this author Stephen J. Freedland Durham, NC More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...