Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Department of Colorectal Surgery, Singapore General Hospital, Singapore, Singapore.
Anticancer Res. 2014 Dec;34(12):7407-14.
Recent observational studies suggest that postoperative aspirin use may improve Colorectal cancer (CRC)-specific survival and overall survival (OS). In this study, we aimed to assess the effects of aspirin use on outcomes in a predominantly Asian cohort of patients with CRC.
Case records of patients undergoing curative resection for stage I-III CRC were retrieved for clinical data and patterns of aspirin use and vital data were determined from hospital electronic prescription records, hospital pharmacy dispensing records, national clinical and prescription databases. CRC-specific and recurrence-free survival (RFS) amongst aspirin users and non-users were analyzed and compared using the Cox proportional hazards model.
Out of 726 patients with CRC, 103 were regular aspirin users and 623 were non-users. The median age of the cohort was 65 years (range=22-94 years) and the majority of patients were Chinese (90%). Nineteen percent, 31% and 47% had stage I, II and III CRC respectively; tumor staging was unknown for 3%. After adjusting for prognostic factors (age, stage, lymph node stage, grade, lesion site, perineural invasion, lymphvascular invasion), the risk of CRC relapse or death from CRC was approximately 60% lower compared to patients who were not postoperative aspirin users (Hazard Ratio=0.38, 95% Confidence Interval=0.17-0.84, p=0.017). No benefit was observed for preoperative use of aspirin.
In this single-Institution study, with long-term follow-up of patients with stage I-III-resected CRC, postoperative aspirin use was associated with reduced risk of relapse of and death from CRC.
最近的观察性研究表明，术后阿司匹林的使用可能改善结直肠癌（CRC）的特异性生存和总生存（OS）。在这项研究中，我们旨在评估阿司匹林的使用对主要为亚洲人群 CRC 患者结局的影响。
我们检索了接受 I-III 期 CRC 根治性切除术患者的病历，以获取临床数据和阿司匹林使用模式，并从医院电子处方记录、医院药房配药记录、国家临床和处方数据库中确定了患者的生存数据。使用 Cox 比例风险模型分析并比较了阿司匹林使用者和非使用者的 CRC 特异性生存和无复发生存（RFS）。
在 726 例 CRC 患者中，有 103 例为常规阿司匹林使用者，623 例为非使用者。该队列的中位年龄为 65 岁（范围为 22-94 岁），大多数患者为中国人（90%）。19%、31%和 47%的患者分别患有 I 期、II 期和 III 期 CRC；3%的患者肿瘤分期未知。在调整了预后因素（年龄、分期、淋巴结分期、分级、病变部位、神经周围侵犯、血管淋巴管侵犯）后，与未术后使用阿司匹林的患者相比，CRC 复发或死于 CRC 的风险降低了约 60%（风险比=0.38，95%置信区间=0.17-0.84，p=0.017）。术前使用阿司匹林未观察到获益。
在这项单机构研究中，对 I-III 期切除 CRC 患者进行了长期随访，术后阿司匹林的使用与降低 CRC 复发和死亡风险相关。
