Upper Gastrointestinal Surgery, Department of Molecular medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
School of Cancer and Pharmaceutical Sciences, King's College London, United Kingdom.
Acta Oncol. 2023 May;62(5):438-443. doi: 10.1080/0284186X.2023.2214681. Epub 2023 May 22.
We hypothesised that the use of the anti-androgenic drug 5α-reductase inhibitors (5-ARIs) improves survival in patients with oesophago-gastric cancer.
This nationwide Swedish population-based cohort study included men who underwent surgery for oesophageal or gastric cancer between 2006-2015, with follow-up until the end of 2020. Multivariable Cox regression estimated hazard ratios (HR) for associations between 5-ARIs use and 5-year all-cause mortality (main outcome) and 5-year disease-specific mortality (secondary outcome). The HR was adjusted for age, comorbidity, education, calendar year, neoadjuvant chemo(radio)therapy, tumour stage, and resection margin status.
Among 1769 patients with oesophago-gastric cancer, 64 (3.6%) were users of 5-ARIs. Compared to non-users, users of 5-ARIs were not at any decreased risk of 5-year all-cause mortality (adjusted HR 1.13, 95% CI 0.79-1.63) or 5-year disease-specific mortality (adjusted HR 1.10, 95% CI 0.79-1.52). Use of 5-ARIs was not associated with any decreased risk of 5-year all-cause mortality in subgroup analyses stratified by categories of age, comorbidity, tumour stage, or tumour subtype (oesophageal or cardia adenocarcinoma, non-cardia gastric adenocarcinoma, or oesophageal squamous cell carcinoma).
This study did not support the hypothesis of improved survival among users of 5-ARIs after curatively intended treatment for oesophago-gastric cancer.
我们假设使用抗雄激素药物 5α-还原酶抑制剂（5-ARIs）可改善接受手术治疗的食管胃结合部癌症患者的生存。
这是一项全国性的瑞典基于人群的队列研究，纳入了 2006-2015 年期间接受食管或胃癌症手术治疗的男性患者，随访至 2020 年底。多变量 Cox 回归估计了 5-ARIs 使用与 5 年全因死亡率（主要结局）和 5 年疾病特异性死亡率（次要结局）之间的关联的风险比（HR）。HR 调整了年龄、合并症、教育程度、日历年份、新辅助化疗（放疗）、肿瘤分期和切缘状态。
在 1769 例食管胃结合部癌症患者中，有 64 例（3.6%）是 5-ARIs 的使用者。与非使用者相比，5-ARIs 使用者在 5 年全因死亡率（调整 HR 1.13，95%CI 0.79-1.63）或 5 年疾病特异性死亡率（调整 HR 1.10，95%CI 0.79-1.52）方面并无降低风险。在按年龄、合并症、肿瘤分期或肿瘤亚型（食管或贲门腺癌、非贲门胃腺癌或食管鳞状细胞癌）分类的亚组分析中，5-ARIs 的使用与 5 年全因死亡率降低无关。
这项研究不支持在接受根治性治疗后，使用 5-ARIs 可改善食管胃结合部癌症患者生存的假设。
