Statins May Reduce Disease Recurrence In Patients With Ulcerated Primary Melanoma

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 center dot 55, 95% confidence Interval (CI) 0 center dot 32-0 center dot 97] regardless of statin subtype or potency. Compared with nonusers of statins, risk of recurrence was significantly decreased in male statin users (HR(adj)0 center dot 39, 95%CI0 center dot 19-0 center dot 79) but not in female statin users (HR(adj)0 center dot 82, 95%CI0 center dot 29-2 center dot 27) and in statin users with ulcerated (HR(adj)0 center dot 17, 95%CI0 center dot 05-0 center dot 52) but not nonulcerated (HR(adj)0 center dot 91, 95%CI0 center dot 46-1 center dot 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. What is already known about this topic?Statins may restrict the cellular functions required for melanoma growth and metastasis. In our cohort of patients with high-risk primary melanoma, long-term statin users had a significantly lower risk of disease recurrence than nonusers. What does this study add?Statins commenced before melanoma diagnosis may reduce the risk of melanoma recurrence, especially in men and in those with ulcerated tumours.