Division of General Surgery, University of Ottawa, Ottawa, Canada; Ottawa Hospital Research Institute, Ottawa, Canada.
Ottawa Hospital Research Institute, Ottawa, Canada; Institute for Clinical and Evaluative Sciences, Toronto, Canada.
Eur J Surg Oncol. 2018 Aug;44(8):1164-1169. doi: 10.1016/j.ejso.2018.05.012. Epub 2018 May 17.
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.
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.
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.
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.
最近的研究表明,β受体阻滞剂的暴露与多种癌症类型的生存改善有关。我们试图研究β受体阻滞剂在乳腺癌、肺癌和结直肠癌指数手术时的作用。
我们使用省级癌症登记处的关联数据,进行了一项回顾性匹配队列研究,比较了 2002 年 4 月 1 日至 2010 年 12 月 31 日期间,年龄在 64 岁以上的患者在乳腺癌、肺癌和结直肠癌指数手术前和手术后β受体阻滞剂暴露与未暴露患者的疾病特异性和总体生存情况。使用高维倾向评分匹配患者,并使用 Cox 比例风险模型估计结局的相对风险。
最终纳入 30020 例患者的匹配队列。乳腺癌、肺癌和结直肠癌的平均随访时间分别为 57.6 ± 30.5、43.1 ± 28.7 和 53.4 ± 31.0 个月。暴露于β受体阻滞剂的患者的疾病特异性死亡率的调整风险比为 1.03(0.83-1.29)乳腺癌、1.05(0.92-1.20)肺癌和 1.10(0.96-1.25)结直肠癌队列。
在这项大型基于人群的研究中,没有发现围手术期β受体阻滞剂暴露与乳腺癌、肺癌或结直肠癌的癌症特异性生存改善之间存在关联。