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Intraoperative use of ketorolac or diclofenac is associated with improved disease-free survival and overall survival in conservative breast cancer surgery.
- Source :
-
British journal of anaesthesia [Br J Anaesth] 2014 Jul; Vol. 113 Suppl 1, pp. i82-7. Date of Electronic Publication: 2014 Jan 23. - Publication Year :
- 2014
-
Abstract
- Background: An association between the use of non-steroidal anti-inflammatory drugs (NSAIDs) and better outcome after mastectomy and lung surgery for cancer has been recently suggested. In a retrospective analysis, we investigated the association between intraoperative NSAIDs use in conservative breast cancer surgery and breast cancer disease-free survival (DFS). Similarly, we also evaluated the association between breast cancer DFS and preoperative neutrophil:lymphocyte ratio (NLR).<br />Methods: A retrospective analysis of a single-centre cohort was performed in breast cancer patients (n=720) with uni- and multivariate analyses, using a Cox regression model.<br />Results: In conservative breast cancer surgery, the intraoperative use of NSAIDs (ketorolac or diclofenac) was associated with an improved DFS {hazard ratio (HR)=0.57 [95% confidence interval (CI): 0.37-0.89], P=0.01} and an improved overall survival (OS) [HR=0.35 (95% CI: 0.17-0.70), P=0.03]. In these patients, an NLR >3.3 (identified by a receiver-operating characteristic curve) was associated with a shorter DFS [HR=1.99 (95% CI: 1.16-3.41), P=0.01] and OS [HR=2.35 (95% CI: 1.02-5.43), P=0.046].<br />Conclusions: Intraoperative NSAIDs and higher preoperative NLR are associated with improved outcome in conservative breast cancer surgery. Prospective, randomized trials to evaluate if these associations are causal are warranted.<br /> (© The Author [2014]. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Anti-Inflammatory Agents, Non-Steroidal administration & dosage
Breast Neoplasms blood
Diclofenac administration & dosage
Disease-Free Survival
Drug Administration Schedule
Drug Evaluation methods
Female
Humans
Kaplan-Meier Estimate
Ketorolac administration & dosage
Lymphocyte Count
Middle Aged
Neutrophils pathology
Prognosis
Retrospective Studies
Treatment Outcome
Anti-Inflammatory Agents, Non-Steroidal therapeutic use
Breast Neoplasms surgery
Diclofenac therapeutic use
Intraoperative Care methods
Ketorolac therapeutic use
Mastectomy, Segmental
Subjects
Details
- Language :
- English
- ISSN :
- 1471-6771
- Volume :
- 113 Suppl 1
- Database :
- MEDLINE
- Journal :
- British journal of anaesthesia
- Publication Type :
- Academic Journal
- Accession number :
- 24464611
- Full Text :
- https://doi.org/10.1093/bja/aet464