El uso de aspirina y la supervivencia después del diagnóstico de cáncer colorrectal
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Andrew T Chan1, Shuji Ogino, Charles S Fuchs
1Gastrointestinal Unit, Massachusetts General Hospital and Harvard Medical School, 55 Fruit St, GRJ 722 Boston, MA 02114, USA. achan@partners.org
JAMA
|August 13, 2009
Resumen
El uso regular de aspirina después del diagnóstico de cáncer colorrectal reduce significativamente la mortalidad específica y general por cáncer colorrectal. Este beneficio de supervivencia es particularmente pronunciado en pacientes cuyos tumores sobreexpresan la ciclooxigenasa 2 (COX-2).
Área de la Ciencia:
- Oncología Oncología Oncología.
- Farmacología Farmacología.
- Epidemiología La epidemiología.
Sus antecedentes:
- La aspirina ha demostrado eficacia en la reducción del riesgo de neoplasia colorrectal e inhibición de la progresión tumoral en modelos preclínicos.
- Sin embargo, su impacto en los resultados de supervivencia después de un diagnóstico de cáncer colorrectal sigue siendo en gran parte inexplorado.
Objetivo del estudio:
- Investigar la asociación entre el uso de aspirina después del diagnóstico y las tasas de supervivencia en pacientes con cáncer colorrectal.
- Para determinar si el uso de aspirina influye en la mortalidad específica por cáncer colorrectal y la mortalidad general.
Principales métodos:
- Un estudio de cohorte prospectivo en el que participaron 1279 pacientes diagnosticados con cáncer colorrectal en estadio I-III.
- Los participantes fueron reclutados de dos cohortes nacionales de profesionales de la salud y fueron seguidos desde el diagnóstico hasta el 1 de junio de 2008.
- Los resultados evaluados incluyeron la mortalidad específica del cáncer colorrectal y la mortalidad general.
Principales resultados:
- El uso regular de aspirina después del diagnóstico se relacionó con un riesgo reducido de mortalidad específica por cáncer colorrectal (HR: 0.71) y mortalidad general (HR: 0.79).
- El uso de aspirina iniciado después del diagnóstico mostró una reducción significativa en la mortalidad específica por cáncer colorrectal (HR: 0.53).
- El beneficio de supervivencia de la aspirina fue significativamente mayor en pacientes con tumores que sobreexpresan la ciclooxigenasa 2 (COX-2) (HR: 0.39) en comparación con aquellos con baja expresión de COX-2.
Conclusiones:
- El uso de aspirina después del diagnóstico se asocia con una mejor supervivencia para los pacientes con cáncer colorrectal.
- Los hallazgos destacan un potencial papel terapéutico de la aspirina, particularmente en pacientes con tumores con sobreexpresión de COX-2.
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