Reilly P Musselman1, Sean Bennett1, Wenbin Li2, Muhammad Mamdani3, Tara Gomes3, Carl van Walraven2, Robin Boushey4, Omar Al-Obeed5, Mohammed Al-Omran6, Rebecca C Auer7. 1. Division of General Surgery, University of Ottawa, Ottawa, Canada; Ottawa Hospital Research Institute, Ottawa, Canada. 2. Ottawa Hospital Research Institute, Ottawa, Canada; Institute for Clinical and Evaluative Sciences, Toronto, Canada. 3. Institute for Clinical and Evaluative Sciences, Toronto, Canada; Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada. 4. Division of General Surgery, University of Ottawa, Ottawa, Canada. 5. King Saud University, Department of Surgery, Riyadh, Saudi Arabia. 6. Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada; King Saud University, Department of Surgery, Riyadh, Saudi Arabia. 7. Division of General Surgery, University of Ottawa, Ottawa, Canada; Ottawa Hospital Research Institute, Ottawa, Canada. Electronic address: rauer@toh.ca.
Abstract
BACKGROUND: Recent studies have demonstrated an association between beta-blocker exposure and improved survival in multiple cancer types. We sought to investigate the effects of beta-blockers at the time of index surgery for breast, lung, and colorectal cancer. MATERIALS AND METHODS: Using linked data from a provincial cancer registry, we conducted a retrospective matched cohort study comparing disease-specific and overall survival between patients over age 64 exposed and not exposed to beta-blockers before and after index surgical resection for breast, lung and colorectal cancer between April 1st, 2002 and December 31st, 2010. A high-dimensional propensity score was used to match patients and Cox proportional hazard models were used to estimate relative risks of the outcomes. RESULTS: 30,020 patients were included in the final matched cohorts. Mean follow up time for breast, lung, and colorectal cancer was 57.6 ± 30.5, 43.1 ± 28.7, and 53.4 ± 31.0 months, respectively. The adjusted hazard ratio for disease-specific mortality for patients exposed to beta-blockers was 1.03 (0.83-1.29) for breast, 1.05 (0.92-1.20) for lung, and 1.10 (0.96-1.25) for the colorectal cancer cohort. CONCLUSIONS: In this large population-based study, no association between perioperative beta-blocker exposure and improved cancer-specific survival for breast, lung, or colorectal cancer was demonstrated.
BACKGROUND: Recent studies have demonstrated an association between beta-blocker exposure and improved survival in multiple cancer types. We sought to investigate the effects of beta-blockers at the time of index surgery for breast, lung, and colorectal cancer. MATERIALS AND METHODS: Using linked data from a provincial cancer registry, we conducted a retrospective matched cohort study comparing disease-specific and overall survival between patients over age 64 exposed and not exposed to beta-blockers before and after index surgical resection for breast, lung and colorectal cancer between April 1st, 2002 and December 31st, 2010. A high-dimensional propensity score was used to match patients and Cox proportional hazard models were used to estimate relative risks of the outcomes. RESULTS: 30,020 patients were included in the final matched cohorts. Mean follow up time for breast, lung, and colorectal cancer was 57.6 ± 30.5, 43.1 ± 28.7, and 53.4 ± 31.0 months, respectively. The adjusted hazard ratio for disease-specific mortality for patients exposed to beta-blockers was 1.03 (0.83-1.29) for breast, 1.05 (0.92-1.20) for lung, and 1.10 (0.96-1.25) for the colorectal cancer cohort. CONCLUSIONS: In this large population-based study, no association between perioperative beta-blocker exposure and improved cancer-specific survival for breast, lung, or colorectal cancer was demonstrated.
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