Perioperative NSAIDs tied to reduced risk for CRC recurrence

  • Schack A & al.
  • Ann Surg Oncol
  • 16 Jul 2019

  • curated by Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • Perioperative treatment with NSAIDs is associated with reduced colorectal cancer (CRC) recurrence, but not reduced 5-year disease-free survival (DFS) or mortality.

Why this matters

  • Inflammation associated with surgery may promote malignant growth.

Study design

  • Retrospective analysis of the Danish Colorectal Cancer Group’s national prospective database (n=2308).
  • Primary analyses were adjusted for age and sex. Multivariate models were adjusted for age at diagnosis, sex, BMI, preoperative oncological treatment, Charlson Comorbidity Index, perioperative blood transfusions, surgical priority, anatomical cancer localization, Union for International Cancer Control stage, and anastomotic leakage.
  • Funding: None.

Key results

  • 909 participants received perioperative NSAIDs (77.2% ibuprofen, 22.4% diclofenac). 1399 did not receive perioperative NSAIDs.
  • 27% of participants had a CRC recurrence. 26% died within 5 years of surgery.
  • There was no statistically significant difference in recurrence between NSAID-treated and -nontreated patients in the primary analysis (HR, 0.94; P=.41).
  • After adjustment, perioperative NSAID treatment was associated with decreased risk for recurrence (aHR, 0.84; P=.042). The competing risk model confirmed this association (aHR, 0.76; P=.026).
  • There was no association between perioperative NSAID use and 5-year mortality or DFS.
  • No association was found in analyses restricted to local disease or elective surgery.

Limitations

  • Retrospective analysis.