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The renin-angiotensin system blockers and survival in digestive system malignancies: A systematic review and

Qi Zhou1, Di-Shi Chen2, Lin Xin1

  • 1Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province.

Medicine
|February 13, 2020
PubMed
Abstract

Insights

Renin-angiotensin system blockers (RASBs) show promise in improving survival for digestive system cancers. This meta-analysis found RASBs significantly enhance overall, cancer-specific, and recurrence-free survival in these patients.

Area of Science:

  • Oncology
  • Pharmacology
  • Gastroenterology

Background:

  • Pre-clinical and clinical studies suggest renin-angiotensin system blockers (RASBs) possess anti-carcinogenic properties.
  • The use of RASBs has been associated with favorable outcomes in various cancer types.

Purpose of the Study:

  • To systematically evaluate the prognostic impact of RASBs on survival outcomes in patients with digestive system malignancies.
  • To synthesize evidence from existing studies through a meta-analysis.

Main Methods:

  • A systematic literature search was conducted across relevant databases up to January 2019.
  • Included studies assessed RASBs' effect on prognostic outcomes in digestive system malignancies.
  • Pooled hazard ratios (HR) with 95% confidence intervals (CIs) were calculated for 13 included studies.

Main Results:

  • RASBs significantly improved overall survival (HR 0.79; 95%CI 0.70-0.89), cancer-specific survival (HR 0.81; 95%CI 0.73-0.90), and recurrence-free survival (HR 0.68; 95%CI 0.54-0.85).
  • No significant improvements were observed in progression-free survival or disease-free survival.
  • Subgroup analysis revealed significant OS benefits in pancreatic, liver, and gastric cancers. Higher doses of RASBs showed a trend towards better survival.

Conclusions:

  • The meta-analysis supports a beneficial association between the use of RASBs and improved survival in patients with digestive system malignancies.
  • RASBs represent a potential therapeutic strategy for enhancing outcomes in these cancers.

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