L. A. von Schuckmann1,2, K. Khosrotehrani3, R. Ghiasvand4, M. C. B. Hughes2, J. C. van der Pols5, M. Malt2, M. Smithers6, A. C. Green2,7
Background: Statins may restrict cellular functions required for melanoma growth and metastasis. We exam- ined whether long-term statin use commenced before diagnosis of the primary is associated with reduced risk of melanoma recurrence.
Patients and methods: We prospectively followed a cohort of patients newly diagnosed between 2010 and 2014 with localised 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 sepa- rately by sex and by presence of ulceration due to evidence of effect modification.
Results: Amongst 700 patients diagnosed with stage T1b to T4b primary melanoma (mean age 62, 59% male, 28% with ulcerated tumors), 94 patients (13%) developed mela- noma recurrence within 2 years. Long-term statin users (n = 204, 29%) had a significantly lower risk of disease recurrence compared to non-users (Adjusted hazard ratio (HRadj) 0.55, 95% Confidence Interval (CI) 0.32–0.97) regardless of statin subtype or potency. Compared to non- statin users, risk of recurrence was significantly decreased in male statin-users (HRadj 0.39, 95% CI: 0.19–0.79) but not 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 non-ulcerated (HRadj 0.91, 95% CI: 0.46–1.81) pri- mary melanoma.
Conclusion: Statins commenced before melanoma diagno- sis, may reduce the risk of melanoma recurrence, espe- cially in males and those with ulcerated tumors. Clinical trial evaluation of the potential role of statins in improving the prognosis of high-risk melanoma is warranted.