Zenghong Huang1,2, Xiaolin Wang2, Qi Zou2,3, Zhuokai Zhuang1,2, Yumo Xie1,2, Du Cai1,2, Liangliang Bai2, Guannan Tang2, Meijin Huang1, Yanxin Luo1, Huichuan Yu4. 1. Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, Guangdong, China. 2. Guangdong Institute of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated Hospital, Sun Yat-sen University, 26 Yuancun Erheng Road, Guangzhou, 510655, Guangdong, China. 3. Department of Colorectal and Anal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, Guangdong, China. 4. Guangdong Institute of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated Hospital, Sun Yat-sen University, 26 Yuancun Erheng Road, Guangzhou, 510655, Guangdong, China. yuhch5@mail.sysu.edu.cn.
Abstract
PURPOSE: Nonsteroidal anti-inflammatory drugs (NSAIDs) have been shown to block tumor-associated inflammation in rectal cancer. However, the perioperative use of NSAIDs remains controversial. This study was designed to investigate whether the perioperative use of NSAIDs influences outcomes and to provide a predictive marker to identify patients who would benefit from NSAIDs. METHODS: We enrolled 515 patients with stage I to III rectal cancer in this retrospective study. Patients were classified into the NSAID and non-NSAID groups according to their perioperative use of NSAIDs. The whole cohort was stratified by platelet-to-lymphocyte ratio (PLR). The primary endpoints were disease-free survival (DFS) and overall survival (OS). RESULTS: The NSAID group had a 12.6% lower risk of recurrence than the non-NSAID group (P = 0.015), while the association with survival was nonsignificant. In the high-PLR subset, the NSAID group had a 17.3% lower risk of recurrence (P = 0.003) and a better DFS (P = 0.033) outcome than the non-NSAID group. Multivariate analysis confirmed this independent significant association with DFS (P = 0.023). In the low-PLR subset, the association of NSAID use with survival was nonsignificant. CONCLUSION: Perioperative use of NSAIDs was associated with improved survival outcomes in rectal cancer patients with high PLR.
PURPOSE: Nonsteroidal anti-inflammatory drugs (NSAIDs) have been shown to block tumor-associated inflammation in rectal cancer. However, the perioperative use of NSAIDs remains controversial. This study was designed to investigate whether the perioperative use of NSAIDs influences outcomes and to provide a predictive marker to identify patients who would benefit from NSAIDs. METHODS: We enrolled 515 patients with stage I to III rectal cancer in this retrospective study. Patients were classified into the NSAID and non-NSAID groups according to their perioperative use of NSAIDs. The whole cohort was stratified by platelet-to-lymphocyte ratio (PLR). The primary endpoints were disease-free survival (DFS) and overall survival (OS). RESULTS: The NSAID group had a 12.6% lower risk of recurrence than the non-NSAID group (P = 0.015), while the association with survival was nonsignificant. In the high-PLR subset, the NSAID group had a 17.3% lower risk of recurrence (P = 0.003) and a better DFS (P = 0.033) outcome than the non-NSAID group. Multivariate analysis confirmed this independent significant association with DFS (P = 0.023). In the low-PLR subset, the association of NSAID use with survival was nonsignificant. CONCLUSION: Perioperative use of NSAIDs was associated with improved survival outcomes in rectal cancerpatients with high PLR.
Authors: Xinwei Hua; Amanda I Phipps; Andrea N Burnett-Hartman; Scott V Adams; Sheetal Hardikar; Stacey A Cohen; Jonathan M Kocarnik; Dennis J Ahnen; Noralane M Lindor; John A Baron; Polly A Newcomb Journal: J Clin Oncol Date: 2017-06-15 Impact factor: 44.544
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: Dipak Panigrahy; Allison Gartung; Jun Yang; Haixia Yang; Molly M Gilligan; Megan L Sulciner; Swati S Bhasin; Diane R Bielenberg; Jaimie Chang; Birgitta A Schmidt; Julia Piwowarski; Anna Fishbein; Dulce Soler-Ferran; Matthew A Sparks; Steven J Staffa; Vidula Sukhatme; Bruce D Hammock; Mark W Kieran; Sui Huang; Manoj Bhasin; Charles N Serhan; Vikas P Sukhatme Journal: J Clin Invest Date: 2019-06-17 Impact factor: 14.808