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Aspirin or statin use in relation to survival after surgery for esophageal cancer : a population-based cohort study

Holmberg, Dag (author)
Karolinska Institutet
Gottlieb-Vedi, Eivind (author)
Karolinska Institutet
Hedberg, Jakob, 1972- (author)
Uppsala universitet,Gastrointestinalkirurgi,Uppsala Univ, Dept Surg Sci, Akad Sjukhuset, Uppsala, Sweden.
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Lindblad, Mats (author)
Karolinska Institutet
Mattsson, Fredrik (author)
Karolinska Inst, Dept Mol Med & Surg, Retzius St 13A,4Th Floor, S-17177 Stockholm, Sweden.;Karolinska Univ Hosp, Retzius St 13A,4Th Floor, S-17177 Stockholm, Sweden.
Lagergren, Jesper (author)
Karolinska Institutet
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 (creator_code:org_t)
BioMed Central (BMC), 2023
2023
English.
In: BMC Cancer. - : BioMed Central (BMC). - 1471-2407. ; 23:1
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Background: Adjuvant postoperative treatment with aspirin and statins may improve survival in several solid tumors. This study aimed to assess whether these medications improve the survival after curatively intended treatment (including esophagectomy) for esophageal cancer in an unselected setting.Methods: This nationwide cohort study included nearly all patients who underwent esophagectomy for esophageal cancer in Sweden from 2006 to 2015, with complete follow-up throughout 2019. Risk of 5-year disease-specific mortality in users compared to non-users of aspirin and statins was analyzed using Cox regression, providing hazard ratios (HR) with 95% confidence intervals (CI). The HRs were adjusted for age, sex, education, calendar year, comorbidity, aspirin/statin use (mutual adjustment), tumor histology, pathological tumor stage, and neoadjuvant chemo(radio)therapy.Results: The cohort included 838 patients who survived at least 1 year after esophagectomy for esophageal cancer. Of these, 165 (19.7%) used aspirin and 187 (22.3%) used statins during the first postoperative year. Neither aspirin use (HR 0.92, 95% CI 0.67-1.28) nor statin use (HR 0.88, 95% CI 0.64-1.23) were associated with any statistically significant decreased 5-year disease-specific mortality. Analyses stratified by subgroups of age, sex, tumor stage, and tumor histology did not reveal any associations between aspirin or statin use and 5-year disease-specific mortality. Three years of preoperative use of aspirin (HR 1.26, 95% CI 0.98-1.65) or statins (HR 0.99, 95% CI 0.67-1.45) did not decrease the 5-year disease-specific mortality.Conclusions: Use of aspirin or statins might not improve the 5-year survival in surgically treated esophageal cancer patients.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

Keyword

Esophageal neoplasm
Chemoprevention
Non-steroidal anti-inflammatory drugs
Chemotherapy
Adjuvant

Publication and Content Type

ref (subject category)
art (subject category)

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