Hackner Danilo, Hobbs Mirianna, Merkel Susanne, Krautz Christian, Weber Georg F, Grützmann Robert, Brunner Maximilian
Department of General and Visceral Surgery, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, 91054 Erlangen, Germany.
Biomedicines. 2023 May 17;11(5):1466. doi: 10.3390/biomedicines11051466.
(1) Background: The intake of aspirin (ASS) has been demonstrated to have a relevant impact on the pathogenesis, incidence and outcome in different solid gastrointestinal tumors. However, data on the effect of ASS on the short-term outcome and the long-term survival in patients with pancreatic carcinoma are still limited. (2) Methods: A total of 213 patients who underwent primary resection of PDAC at the University Hospital of Erlangen from January 2000 to December 2018 were included in this retrospective single-center study in total. Patients were stratified according to the aspirin intake into three groups: continuous aspirin intake (cASS), perioperatively interrupted aspirin intake (iASS) and no aspirin intake (no ASS) at the timepoint of surgery. The postoperative outcome as well as long-term survival were compared between the groups. (3) Results: There were no differences regarding postoperative morbidity (iASS: 54% vs. cASS: 53% vs. no ASS: 64%, = 0.448) and in-hospital mortality (iASS: 4% vs. cASS: 10% vs. no ASS: 3%, = 0.198) between the groups. The overall survival (OS) and disease-free survival (DFS) did not differ in the groups when comparing the ASS-intake status (OS: iASS 17.8 months vs. cASS 19.6 months vs. no ASS 21.6 months, = 0.489; DFS: iASS 14.0 months vs. cASS 18.3 months vs. no ASS 14.7 months, = 0.957). Multivariate analysis revealed that age (hazard ratio (HR) 2.2, < 0.001), lymph node-positive status (HR 2.0, < 0.001), R status 1 or 2 (HR 2.8, < 0.001) and differentiation with a grading of 3 (HR 1.7, = 0.005) were significant independent prognostic factors regarding the OS. Moreover, age (HR 1.5, = 0.040), lymph node-positive status (HR 1.8, = 0.002) and high-grade (G3) carcinomas (HR 1.5, = 0.037) could be identified as independent prognostic parameters for DFS. (4) Conclusions: In patients undergoing primary surgery for curative resection of pancreatic carcinoma, the perioperative intake of ASS had no significant impact on postoperative outcome, overall and disease-free survival.
(1) 背景：已证实阿司匹林（ASS）的摄入对不同实体胃肠道肿瘤的发病机制、发病率及预后有显著影响。然而，关于ASS对胰腺癌患者短期预后和长期生存影响的数据仍然有限。(2) 方法：本回顾性单中心研究共纳入2000年1月至2018年12月在埃尔朗根大学医院接受胰腺癌根治性切除术的213例患者。根据手术时阿司匹林的摄入情况将患者分为三组：持续服用阿司匹林（cASS）、围手术期中断服用阿司匹林（iASS）和未服用阿司匹林（未服用ASS）。比较各组的术后结局及长期生存情况。(3) 结果：各组间术后发病率（iASS：54% vs. cASS：53% vs. 未服用ASS：64%，P = 0.448）和院内死亡率（iASS：4% vs. cASS：10% vs. 未服用ASS：3%，P = 0.198）无差异。比较ASS摄入状态时，各组的总生存期（OS）和无病生存期（DFS）无差异（OS：iASS 17.8个月 vs. cASS 19.6个月 vs. 未服用ASS 21.6个月，P = 0.489；DFS：iASS 14.0个月 vs. cASS 18.3个月 vs. 未服用ASS 14.7个月，P = 0.957）。多因素分析显示，年龄（风险比（HR）2.2，P < 0.001）、淋巴结阳性状态（HR 2.0，P < 0.001）、R状态为1或2（HR 2.8，P < 0.001）以及分化程度为3级（HR 1.7，P = 0.005）是OS的显著独立预后因素。此外，年龄（HR 1.5，P = 0.040）、淋巴结阳性状态（HR 1.8，P = 0.002）和高级别（G3）癌（HR 1.5，P = 0.037）可被确定为DFS的独立预后参数。(4) 结论：在接受胰腺癌根治性手术的患者中，围手术期服用ASS对术后结局、总生存期和无病生存期无显著影响。
