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Research article
The impact of preoperative use of calcium channel blockers on outcomes of patients undergoing esophagectomy: a propensity score-matched cohort study
longhui cao
Sun Yat-sen University Cancer Center
Corresponding Author
ORCiD: https://orcid.org/0000-0002-0008-0210
License:
This work is licensed under a CC BY 4.0 License. Read Full License
BACKGROUND
In this study, we compared the effects of using preoperative CCBs on perioperative outcomes, cancer recurrence and overall survival in patients undergoing esophagectomy.
METHODS
A retrospective cohort study was performed on patients who underwent esophagectomy at the Sun Yat-Sen University Cancer Center (n=2415, 2009-2013). Univariate and multivariate logistic regression analyses were performed to assess the perioperative outcomes, while recurrence-free survival and overall survival were assessed using Kaplan-Meier survival estimates and compared using a multivariate Cox proportional hazards regression, adjusted with propensity scores.
RESULTS
There were 162 patients in the CCB group and 1110 patients in the non-CCB group and the total incidence of perioperative complications was 45.7% in the CCB group and 42.5% in the non-CCB group. The differences in total perioperative complications and other perioperative outcomes were not significantly different between the two groups (P>0.05). The mortality rate was not significantly different between the two groups after matching (38.1% vs 31.6%, P=0.233). The difference in recurrence rate between the two groups was not statistically significant after matching (43.2% vs 32.9%, P = 0.061). Overall survival was shorter in patients with preoperative CCB use than in patients without CCB use (hazards ratio: 1.517, 95% confidence intervals (CI): 1.036-2.220, P=0.030). The multivariate Cox proportional hazards regression adjusted with propensity scores found that a history of smoking cigarettes, clinical stage III at diagnosis, preoperative CCB use, preoperative diuretics use, operation type and postoperative chemotherapy affected the overall survival of patients after esophagectomy. Recurrence-free survival was similar between the CCB and non-CCB groups (HR: 1.425, 95%CI: 0.989-2.053, P=0.054). A history of chronic lung disease, hypertension, and preoperative use of beta-blockers affected the recurrence-free survival of patients after esophagectomy.
CONCLUSION
Preoperative CCBs use was associated with shorter overall survival but did not affect recurrence-free survival or the postoperative complications for patients undergoing esophagectomy.
Keywords
CCB, esophagectomy, perioperative outcomes
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This is a preprint. It has not completed peer review.
Research article
The impact of preoperative use of calcium channel blockers on outcomes of patients undergoing esophagectomy: a propensity score-matched cohort study
longhui cao
Sun Yat-sen University Cancer Center
Corresponding Author
ORCiD: https://orcid.org/0000-0002-0008-0210
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 17 Jan, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
BACKGROUND
In this study, we compared the effects of using preoperative CCBs on perioperative outcomes, cancer recurrence and overall survival in patients undergoing esophagectomy.
METHODS
A retrospective cohort study was performed on patients who underwent esophagectomy at the Sun Yat-Sen University Cancer Center (n=2415, 2009-2013). Univariate and multivariate logistic regression analyses were performed to assess the perioperative outcomes, while recurrence-free survival and overall survival were assessed using Kaplan-Meier survival estimates and compared using a multivariate Cox proportional hazards regression, adjusted with propensity scores.
RESULTS
There were 162 patients in the CCB group and 1110 patients in the non-CCB group and the total incidence of perioperative complications was 45.7% in the CCB group and 42.5% in the non-CCB group. The differences in total perioperative complications and other perioperative outcomes were not significantly different between the two groups (P>0.05). The mortality rate was not significantly different between the two groups after matching (38.1% vs 31.6%, P=0.233). The difference in recurrence rate between the two groups was not statistically significant after matching (43.2% vs 32.9%, P = 0.061). Overall survival was shorter in patients with preoperative CCB use than in patients without CCB use (hazards ratio: 1.517, 95% confidence intervals (CI): 1.036-2.220, P=0.030). The multivariate Cox proportional hazards regression adjusted with propensity scores found that a history of smoking cigarettes, clinical stage III at diagnosis, preoperative CCB use, preoperative diuretics use, operation type and postoperative chemotherapy affected the overall survival of patients after esophagectomy. Recurrence-free survival was similar between the CCB and non-CCB groups (HR: 1.425, 95%CI: 0.989-2.053, P=0.054). A history of chronic lung disease, hypertension, and preoperative use of beta-blockers affected the recurrence-free survival of patients after esophagectomy.
CONCLUSION
Preoperative CCBs use was associated with shorter overall survival but did not affect recurrence-free survival or the postoperative complications for patients undergoing esophagectomy.
Figure 1
Figure 2
Figure 3