Uso de ácido acetilsalicílico, metformina e estatinas e o cancro da próstata: impacto sobre as características patológicas e risco de recidiva bioquímica

Abstract

Background

The impact of using ASA (acetylsalicylic acid), metformin and statins on the prostate cancer may be significant, but is not clear and findings from previous studies are inconsistent. This study aims to evaluate the relationship between the use of ASA, metformin and statins and the pathological characteristics and risk of biochemical recurrence (BCR) of prostate cancer.

Methods

A total of 311 patients submitted to radical prostatectomy (RP) at Hospital de Braga between January 2010 and June 2014 were analyzed. Data were obtained from clinical records and the crude and adjusted association between the use of a specific drug and prostate specific antigen (PSA), pathological stage, Gleason score, positive surgical margin and risk of biochemical recurrence were calculated.

Findings

Overall, 26 (8.4%) of the patients used ASA, 35 (11.3%) metformin and 112 (36%) statins. The ASA users had a lower PSA compared with the non users (5.9 vs. 8.9 ng/m; p = 0.008). Its use was an independent predictor of positive surgical margin (OR = 3.77; IC 95%: 1.45‐9.78). The use of metformin was associated with advanced pathological stages, more precisely pT3b (20% vs. 7.7%; p = 0.048). No other differences were detected between ASA, metformin and statins users.

Conclusions

The use of ASA, metformin and statins has no beneficial effect on prostatic cancer patients. On the opposite, an association between the use of metformin and advanced pathological stages was observed. These results should be validated in other larger samples and longer follow‐up. The association between the use of ASA and lower PSA was already detected in other studies, whose mechanism should be clarified in future