Statins may reduce disease recurrence in patients with ulcerated primary melanoma
Lena A. von Schuckmann, Kiarash Khosrotehrani, Reza Ghiasvand, M. C. Hughes, Jolieke C. van der Pols, M. Malt, B. Mark Smithers, Adèle C. Green
Abstract
Background Statins may restrict the cellular functions required for melanoma growth and metastasis. Objectives To determine whether long-term statin use commenced before diagnosis of a primary melanoma is associated with reduced risk of melanoma recurrence. Methods We prospectively followed a cohort of patients newly diagnosed between 2010 and 2014 with localized tumour-stage T1b to T4b melanoma in Queensland, Australia. We used Cox regression analyses to examine associations between long-term statin use and melanoma recurrence for the entire cohort, and then separately by sex and by presence of ulceration, due to evidence of effect modification. Results Among 700 patients diagnosed with stage T1b to T4b primary melanoma (mean age 62 years, 59% male, 28% with ulcerated tumours), 94 patients (13%) developed melanoma recurrence within 2 years. Long-term statin users (n = 204, 29%) had a significantly lower risk of disease recurrence than nonusers [adjusted hazard ratio (HRadj) 0·55, 95% confidence Interval (CI) 0·32–0·97] regardless of statin subtype or potency. Compared with nonusers of statins, risk of recurrence was significantly decreased in male statin users (HRadj 0·39, 95% CI 0·19–0·79) but not in female statin users (HRadj 0·82, 95% CI 0·29–2·27) and in statin users with ulcerated (HRadj 0·17, 95% CI 0·05–0·52) but not nonulcerated (HRadj 0·91, 95% CI 0·46–1·81) primary melanoma. Conclusions Statins commenced before melanoma diagnosis may reduce the risk of melanoma recurrence, especially in men and in those with ulcerated tumours. Clinical trial evaluation of the potential role of statins in improving the prognosis of high-risk melanoma is warranted.