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Postoperative Impact of Anti-Inflammatory Drug on Cancer Recurrence in Patients With Locally Advanced Gastric Cancer
Ryota Matsui1,2, Manabu Ohashi1, Motonari Ri1
1Department of Gastroenterological Surgery The Cancer Institute Hospital of Japanese Foundation for Cancer Research Tokyo Japan.
Background:
Elevated postoperative inflammation is associated with reduced recurrence-free survival (RFS) after gastrectomy in patients with gastric cancer, independent of postoperative complications. The effect of the administration of anti-inflammatory drugs immediately after gastrectomy on prolonging RFS in patients with gastric cancer has not been fully investigated. In this study, we aimed to investigate the effects of anti-inflammatory drugs on the long-term recurrence rates of gastric cancer after radical resection.
Methods:
This retrospective cohort study included consecutive patients who underwent radical gastrectomy for primary pStage II-III gastric cancer between May 2006 and March 2017. We performed propensity score matching using a logistic regression model to adjust for patient background, compared RFS, and used Cox proportional hazard regression to identify prognostic factors.
Results:
Median duration of follow-up was 62 months. After matching, 591 patients were included in the untreated group, and 197 were included in the group treated with anti-inflammatory drugs. RFS was no significant difference in the two groups (5-year RFS: treated group, 73.2%; untreated group, 68.4%; p = 0.246), but peritoneal recurrence was significantly lower in the treated group (p = 0.028). Multivariate analyses showed that anti-inflammatory drugs were independent prognostic factors for recurrence-free survival (hazard ratio, 0.751; 95% confidence interval, 0.569-0.992; p = 0.044). In the subgroup analysis, using multivariate analysis for recurrence-free survival, anti-inflammatory drugs were more effective in patients with pStage III than in those with pStage II disease.
Conclusion:
Anti-inflammatory drug administration after radical resection may prolong recurrence-free survival in patients with pStage III gastric cancer.
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