Prediagnosis aspirin use and outcomes in a prospective cohort of esophageal cancer patients.
Prediagnosis aspirin use and outcomes in a prospective cohort of esophageal cancer patients.
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DOI：
10.1177/1756283x16657985
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发表时间：
2016-11
影响因子：
4.2
通讯作者：
Abrams JA
中科院分区：
文献类型：
--
作者：
Araujo JL;Altorki NK;Sonett JR;Rodriguez A;Sungur-Stasik K;Spinelli CF;Neugut AI;Abrams JA
食道癌仍然与预后不良有关，但人们对影响生存的因素知之甚少。在癌症诊断之前使用阿司匹林可能会影响结果。我们的目的是评估食管癌患者诊断前使用阿司匹林的效果。我们对两个三级医疗中心新诊断的食管癌患者进行了一项前瞻性队列研究。我们评估了诊断前阿司匹林使用史，前瞻性随访患者，评估死亡率、死亡原因和转移的发展。我们入组了130例患者，其中大多数为男性（81.5%）和腺癌（80.8%）。总体而言，57名患者（43.9%）定期服用阿司匹林。在未经调整的分析中，我们发现阿司匹林使用者和非使用者之间的全因死亡率没有差异。在多变量分析中，诊断前使用阿司匹林与全因死亡率[风险比（HR）0.86，95%置信区间（CI）0.48-1.57]或食管癌特异性死亡率（HR 1.07，95% CI 0.52-2.21）无关。诊断前使用阿司匹林与间期转移风险显著增加相关（HR 3.59，95% CI 1.08-11.96）。在我们的食管癌患者队列中，诊断前使用阿司匹林与全因或癌症特异性死亡率无关。然而，在诊断前定期服用阿司匹林的患者中，间歇性转移性疾病的风险增加。未来的研究是必要的，以评估阿司匹林是否影响食管肿瘤的分子特征，具有潜在的预后和治疗意义。
Esophageal cancer remains associated with poor outcomes, yet little is known regarding factors that influence survival. Aspirin use prior to cancer diagnosis may influence outcomes. We aimed to assess the effects of prediagnosis aspirin use in patients with esophageal cancer. We conducted a prospective cohort study of newly-diagnosed esophageal cancer patients at two tertiary care centers. We assessed history of prediagnosis aspirin use, and prospectively followed patients and assessed mortality, cause of death, and development of metastases. We enrolled 130 patients, the majority of whom were male (81.5%) and had adenocarcinoma (80.8%). Overall, 57 patients (43.9%) were regular aspirin users. In unadjusted analyses, we found no difference in all-cause mortality between aspirin users and nonusers. In multivariate analyses, prediagnosis aspirin use was not associated with all-cause mortality [hazard ratio (HR) 0.86, 95% confidence interval (CI) 0.48–1.57] or esophageal cancer-specific mortality (HR 1.07, 95% CI 0.52–2.21). Prediagnosis aspirin use was associated with a significantly increased risk of interval metastasis (HR 3.59, 95% CI 1.08–11.96). In our cohort of esophageal cancer patients, prediagnosis aspirin use was not associated with all-cause or cancer-specific mortality. However, risk of interval metastatic disease was increased among those who took aspirin regularly prediagnosis. Future studies are warranted to assess whether aspirin influences the molecular characteristics of esophageal tumors, with potential prognostic and therapeutic implications.