The potential benefits of concomitant statins treatment in patients with non‐muscle‐invasive bladder cancer

Objective To investigate the influence of statins on the survival outcomes of patients with non‐muscle‐invasive bladder cancer (NMIBC) treated with adjuvant intravesical bacille Calmette‐Guérin (BCG) immunotherapy. Patients and Methods A retrospective cohort of consecutive patients with NMIBC who received intravesical BCG therapy from 2001 to 2020 and statins prescription were identified. Overall survival (OS), cancer‐specific survival (CSS), recurrence‐free survival (RFS), and progression‐free survival (PFS) were analysed between the Statins Group vs No‐Statins Group using Kaplan–Meier method and multivariable Cox regression. Results A total of 2602 patients with NMIBC who received intravesical BCG were identified. The median follow‐up was 11.0 years. On Kaplan–Meier analysis, the Statins Group had significant better OS ( P < 0.001), CSS ( P < 0.001), and PFS ( P < 0.001). Subgroup analysis indicated statins treatment started before BCG treatment had better CSS ( P = 0.02) and PFS ( P < 0.01). Upon multivariable Cox regression analysis, the ‘statins before BCG’ group was an independent protective factor for OS (hazard ratio [HR] 0.607, 95% confidence interval [CI] 0.514–0.716), and CSS (HR 0.571, 95% CI 0.376–0.868), but not RFS (HR 0.885, 95% CI 0.736–1.065), and PFS (HR 0.689, 95% CI 0.469–1.013). Conclusions Statins treatment appears to offer protective effects on OS and CSS for patients with NMIBC receiving adjuvant intravesical BCG.