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Chemopreventive Agents After Pancreatic Resection for Ductal Adenocarcinoma: Legend or Scientific Evidence?
- Source :
- Annals of surgical oncology. 28(4)
- Publication Year :
- 2020
-
Abstract
- Background: Pancreatic ductal adenocarcinoma (PDAC) is currently the fourth leading cause of cancer-related death in the USA. A wealth of evidence has demonstrated the chemopreventive activity of aspirin, statins, and metformin against PDAC. The aim of this study is to investigate the effect of aspirin, statins, and metformin on disease-free survival (DFS) and disease-specific survival (DSS) in a large population of PDAC patients undergoing pancreatic resection. Patients and Methods: All patients who underwent pancreatic resections between January 2015 and September 2018 were retrospectively reviewed. The potentially “chemopreventive agents” considered for the analysis were aspirin, statins, and metformin. Drug use was defined in case of regular assumption at least 6months before diagnosis and regularly after surgery along the follow-up period. Results: A total of 430 patients were enrolled in this study, with median DFS and DSS of 21months (IQR 13–30) months and 34 (IQR 26–52) months, respectively. On multivariable analysis, use of aspirin was associated with better DFS (HR: 0.62; p = 0.038). Metformin was associated with better DFS, without reaching statistical significance (p = 0.083). Use of statins did not influence DFS in the studied population. Aspirin, metformin, and statins were not associated with better DSS on multivariable analysis. Factors influencing DSS were pT3/pT4, N1, N2, no adjuvant treatment, G3, and ASA score > 3. Conclusions: The results suggest that chronic use of aspirin is associated with increased DFS but not with better DSS after surgical resection in patients with PDAC.
- Subjects :
- Oncology
medicine.medical_specialty
endocrine system diseases
medicine.medical_treatment
Population
Breast Neoplasms
03 medical and health sciences
0302 clinical medicine
Pancreatectomy
Surgical oncology
Statistical significance
Internal medicine
Medicine
Humans
Ductal adenocarcinoma
Pancreatic resection
education
Retrospective Studies
education.field_of_study
Aspirin
business.industry
nutritional and metabolic diseases
Prognosis
digestive system diseases
Metformin
Pancreatic Neoplasms
stomatognathic diseases
030220 oncology & carcinogenesis
030211 gastroenterology & hepatology
Surgery
business
Adjuvant
medicine.drug
Carcinoma, Pancreatic Ductal
Subjects
Details
- ISSN :
- 15344681
- Volume :
- 28
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Annals of surgical oncology
- Accession number :
- edsair.doi.dedup.....e6cfee92c355381618bc5c38777bc758