Perioperative beta-blocker use and survival in lung cancer patients
Perioperative beta-blocker use and survival in lung cancer patients
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DOI：
10.1016/j.jclinane.2013.10.004
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发表时间：
2014-03-01
影响因子：
6.7
通讯作者：
Gottumukkala, Vijaya
中科院分区：
文献类型：
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作者：
Cata, Juan P.;Villarreal, John;Gottumukkala, Vijaya
研究目的：评估围手术期β受体阻滞剂对非小细胞肺癌手术后复发和总生存率的影响。设计：回顾性研究。地点：学术医疗中心。 测量：将 1、2 和 3a 期非小细胞肺癌患者的病历分为三个不同组：围手术期从未接受过 β 受体阻滞剂的患者、术后 60 天内接受非选择性 β 受体阻滞剂的患者以及术后 60 天内服用选择性 β 受体阻滞剂的患者。无复发生存率和总生存率是主要的临床终点。使用单变量对数秩检验和多变量 Cox 比例风险模型来评估选择性 β 阻滞剂、非选择性 β 阻滞剂或不使用 β 阻滞剂对无复发生存率和总生存率的影响。 主要结果：分析包括 435 名患者的记录。单变量分析显示，选择性和非选择性β受体阻滞剂的使用与无复发生存期（P = 0.014）和总生存期（P = 0.009）的降低相关。然而，在调整多变量分析中可能的混杂变量后，这些发现并没有得到证实。无复发生存的风险比（选择性β受体阻滞剂与不使用β受体阻滞剂为：1.304；95%置信区间[CI] 0.973 - 1.747；P = 0.075；非选择性β受体阻滞剂与不使用β受体阻滞剂：0.989；95% CI 0.639 - 1.532；P = 0.962。 总生存的风险比为：选择性β受体阻滞剂使用与不使用β受体阻滞剂：1.335；95% CI 0.966 - 1.846；P = 0.080；非选择性β受体阻滞剂使用与不使用β受体阻滞剂：1.108；95% CI 0.678 - 1.812；P = 0.682。接受非小细胞肺癌切除术的患者的总体生存率 (C) 2014 Elsevier Inc. 保留所有权利。
Study Objective: To assess the effect of perioperative beta blockers on recurrence and overall survival after non-small cell lung cancer surgery.Design: Retrospective study. Setting: Academic medical center.Measurements: The medical records of patients with stage 1, 2, and 3a non-small cell lung cancer were divided into three different groups: those patients who never received beta blockers perioperatively, those receiving nonselective beta blockers within 60 days of surgery, and those taking selective beta blockers within 60 days of surgery. Recurrence-free survival and overall survival were the main clinical endpoints. Univariate log-rank tests and multivariate Cox proportional hazards models were used to assess the effects of selective beta blockers, nonselective beta blockers, or no beta blockers on recurrence-free survival and overall survival.Main Results: The analysis included records of 435 patients. Univariate analyses showed that the use of both selective and nonselective beta blockers was associated with decreased recurrence-free survival (P = 0.014) and overall survival (P = 0.009). However, these findings were not sustained after adjusting for possible confounding variables in the multivariate analysis. The hazard ratios for recurrence-free survival (selective beta blockers vs no beta blocker use were: 1.304; 95% confidence intervals [CI] 0.973 - 1.747; P = 0.075; for nonselective beta blockers vs no beta blockers: 0.989; 95% CI 0.639 - 1.532; P = 0.962. The hazard ratios for overall survival were: selective beta blocker use vs no beta blockers: 1.335; 95% CI 0.966 - 1.846; P = 0.080; nonselective beta blocker use vs no beta blocker use: 1.108; 95% CI 0.678 - 1.812; P = 0.682.Conclusion: Administration of beta blockers during the perioperative period did not improve recurrence-free or overall survival in patients undergoing resection of non-small cell lung cancer. (C) 2014 Elsevier Inc. All rights reserved.