Theodore M Brasky1, Ashley S Felix2,3,4, David E Cohn5, D Scott McMeekin6, David G Mutch7, William T Creasman8, Premal H Thaker7, Joan L Walker9, Richard G Moore10, Shashikant B Lele11, Saketh R Guntupalli12, Levi S Downs13, Christa I Nagel14, John F Boggess15, Michael L Pearl16, Olga B Ioffe17, Kay J Park18, Shamshad Ali19, Louise A Brinton3. 1. Division of Cancer Prevention and Control, Ohio State University, Columbus, OH, USA. 2. College of Medicine, and Division of Epidemiology, College of Public Health, Ohio State University, Columbus, OH, USA. 3. Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA. 4. Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA. 5. Division of Gynecologic Oncology, Ohio State University, Columbus, OH, USA. 6. Stephenson Oklahoma Cancer Center, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Oklahoma, USA. 7. Washington University School of Medicine, St. Louis, MO, USA. 8. Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA. 9. Department of Obstetrics and Gynecology, University of Oklahoma, Oklahoma City, OK, USA. 10. Program in Women's Oncology, Department of Obstetrics and Gynecology, Women and Infants Hospital/Brown University, Providence, RI, USA. 11. Gynecologic Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA. 12. Gynecologic Oncology, University of Colorado Cancer Center, Aurora, CO, USA. 13. Gynecologic Oncology, University of Minnesota, Minneapolis, MN, USA. 14. Division of Gynecologic Oncology, Case Western Reserve University, Cleveland, OH, USA. 15. Gynecologic Oncology Program, University of North Carolina, Chapel Hill, NC, USA. 16. Gynecologic Oncology, State University of New York at Stonybrook, Stonybrook, NY , USA. 17. Anatomical Pathology, University of Maryland, College Park, MD, USA. 18. Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA. 19. NRG Statistics and Data Management Center, Roswell Park Cancer Institute, Buffalo, NY, USA.
Abstract
Background: Recent data suggest that the use of nonsteroidal anti-inflammatory drugs (NSAIDs) may be associated with reductions in endometrial cancer risk, yet very few have examined whether their use is related to prognosis among endometrial cancer patients. Methods: Study subjects comprised 4374 participants of the NRG Oncology/Gynecology Oncology Group 210 Study with endometrial carcinoma who completed a presurgical questionnaire that assessed history of regular prediagnostic NSAID use and endometrial cancer risk factors. Recurrences, vital status, and causes of death were obtained from medical records and cancer registries. Fine-Gray semiproportional hazards regression estimated adjusted subhazard ratios (HRs) and 95% confidence intervals (CIs) for associations of NSAID use with endometrial carcinoma-specific mortality and recurrence. Models were stratified by endometrial carcinoma type (ie, type I [endometrioid] vs type II [serous, clear cell, or carcinosarcoma]) and histology. Results: Five hundred fifty endometrial carcinoma-specific deaths and 737 recurrences occurred during a median of five years of follow-up. NSAID use was associated with 66% (HR = 1.66, 95% CI = 1.21 to 2.30) increased endometrial carcinoma-specific mortality among women with type I cancers. Associations were statistically significant for former and current users, and strongest among former users who used NSAIDs for 10 years or longer (HR = 2.23, 95% CI = 1.19 to 4.18, two-sided P trend = .01). NSAID use was not associated with recurrence or endometrial carcinoma-specific mortality among women with type II tumors. Conclusions: In this study, use of NSAIDs was associated with increased endometrial carcinoma-specific mortality, especially in patients with type I tumors. Barring a clear biologic mechanism by which NSAIDs would increase the risk of cause-specific mortality, cautious interpretation is warranted.
Background: Recent data suggest that the use of nonsteroidal anti-inflammatory drugs (NSAIDs) may be associated with reductions in endometrial cancer risk, yet very few have examined whether their use is related to prognosis among endometrial cancerpatients. Methods: Study subjects comprised 4374 participants of the NRG Oncology/Gynecology Oncology Group 210 Study with endometrial carcinoma who completed a presurgical questionnaire that assessed history of regular prediagnostic NSAID use and endometrial cancer risk factors. Recurrences, vital status, and causes of death were obtained from medical records and cancer registries. Fine-Gray semiproportional hazards regression estimated adjusted subhazard ratios (HRs) and 95% confidence intervals (CIs) for associations of NSAID use with endometrial carcinoma-specific mortality and recurrence. Models were stratified by endometrial carcinoma type (ie, type I [endometrioid] vs type II [serous, clear cell, or carcinosarcoma]) and histology. Results: Five hundred fifty endometrial carcinoma-specific deaths and 737 recurrences occurred during a median of five years of follow-up. NSAID use was associated with 66% (HR = 1.66, 95% CI = 1.21 to 2.30) increased endometrial carcinoma-specific mortality among women with type I cancers. Associations were statistically significant for former and current users, and strongest among former users who used NSAIDs for 10 years or longer (HR = 2.23, 95% CI = 1.19 to 4.18, two-sided P trend = .01). NSAID use was not associated with recurrence or endometrial carcinoma-specific mortality among women with type II tumors. Conclusions: In this study, use of NSAIDs was associated with increased endometrial carcinoma-specific mortality, especially in patients with type I tumors. Barring a clear biologic mechanism by which NSAIDs would increase the risk of cause-specific mortality, cautious interpretation is warranted.
Authors: Anna E Coghill; Polly A Newcomb; Peter T Campbell; Andrea N Burnett-Hartman; Scott V Adams; Elizabeth M Poole; John D Potter; Cornelia M Ulrich Journal: Gut Date: 2010-11-04 Impact factor: 23.059
Authors: Kimmie Ng; Jeffrey A Meyerhardt; Andrew T Chan; Kaori Sato; Jennifer A Chan; Donna Niedzwiecki; Leonard B Saltz; Robert J Mayer; Al B Benson; Paul L Schaefer; Renaud Whittom; Alexander Hantel; Richard M Goldberg; Alan P Venook; Shuji Ogino; Edward L Giovannucci; Charles S Fuchs Journal: J Natl Cancer Inst Date: 2014-11-27 Impact factor: 13.506
Authors: Bernard F Cole; Richard F Logan; Susan Halabi; Robert Benamouzig; Robert S Sandler; Matthew J Grainge; Stanislas Chaussade; John A Baron Journal: J Natl Cancer Inst Date: 2009-02-10 Impact factor: 13.506
Authors: Theodore M Brasky; Jingmin Liu; Emily White; Ulrike Peters; John D Potter; Roland B Walter; Christina S Baik; Dorothy S Lane; JoAnn E Manson; Mara Z Vitolins; Matthew A Allison; Jean Y Tang; Jean Wactawski-Wende Journal: Int J Cancer Date: 2014-03-20 Impact factor: 7.396
Authors: Elizabeth M Poole; Wayne T Lin; Marina Kvaskoff; Immaculata De Vivo; Kathryn L Terry; Stacey A Missmer Journal: Cancer Causes Control Date: 2017-03-15 Impact factor: 2.506
Authors: Jason Roszik; J Jack Lee; Yi-Hung Wu; Xi Liu; Masanori Kawakami; Jonathan M Kurie; Anas Belouali; Simina M Boca; Samir Gupta; Robert A Beckman; Subha Madhavan; Ethan Dmitrovsky Journal: Cancer Res Commun Date: 2022-07-06
Authors: Hong Im Kim; Chad R Schultz; Andrea L Buras; Elizabeth Friedman; Alyssa Fedorko; Leigh Seamon; Gadisetti V R Chandramouli; G Larry Maxwell; André S Bachmann; John I Risinger Journal: PLoS One Date: 2017-12-14 Impact factor: 3.240