School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Foresterhill Health Campus, Aberdeen, AB25 2ZD, UK.
Department of Anaesthesia, NHS Grampian, Aberdeen, UK.
Curr Oncol Rep. 2021 Nov 8;23(12):146. doi: 10.1007/s11912-021-01133-8.
This review investigated the use of perioperative non-steroidal anti-inflammatory drugs (NSAIDs) and long-term outcomes in cancer surgery patients, and whether this is dependent on cancer type, type of NSAID and timing of administration.
Perioperative NSAID use was found to be associated with longer disease-free survival (hazard ration, HR = 0.84 (95% CI, 0.73-0.97)) and overall survival (HR = 0.78 (95% CI, 0.64-0.94)). No difference was found between different types of NSAID for disease-free survival, although in overall survival ketorolac use was significant (HR = 0.63 (95% CI, 0.42-0.95)). Analysis on the timing of NSAID administration found no subgroup to be associated with cancer outcomes. The cancer-type analysis found an association with outcomes in breast and ovarian cancers. However, the level of certainty remains very low, mostly due to the heterogeneity and the retrospective nature of most studies. Perioperative NSAID use may be associated with increased disease-free and overall survival after cancer surgery. This may be dependent on the type of cancer and type of NSAID, and further research is needed to support this. These data may inform future prospective trials, which are needed to determine the clinical impact, as well as optimal NSAID regimen.
本综述研究了围手术期非甾体抗炎药（NSAIDs）在癌症手术患者中的应用及其与长期预后的关系，以及这种关系是否取决于癌症类型、NSAID 类型和给药时间。
围手术期使用 NSAIDs 与无病生存率（危险比，HR=0.84（95%可信区间，0.73-0.97））和总生存率（HR=0.78（95%可信区间，0.64-0.94））延长相关。不同类型的 NSAID 对无病生存率无差异，但在总生存率方面，酮咯酸的使用具有显著意义（HR=0.63（95%可信区间，0.42-0.95））。对 NSAID 给药时间的分析发现，没有亚组与癌症结局相关。癌症类型分析发现与乳腺癌和卵巢癌的结局相关。然而，由于大多数研究的异质性和回顾性，其确定性水平仍然非常低。围手术期使用 NSAIDs 可能与癌症手术后无病生存率和总生存率的提高有关。这可能取决于癌症类型和 NSAID 类型，需要进一步研究来支持这一点。这些数据可能为未来的前瞻性试验提供信息，以确定临床影响以及最佳 NSAID 方案。
