Drug Allergy and the Risk of Lymph Node Metastasis in Rectal Cancer

Abstract

BackgroundPrevious epidemiologic studies have reported that a history of allergy is associated with reduced risk of colorectal cancer and other malignancies. However, no information is available for the association between allergy and the risk of lymph node metastasis. Our study was designed to determine this association in rectal cancer.MethodsPatients who were treated at our hospital in the period from January 2003 to June 2011, and with a pathologically hospital discharge diagnosis of rectal adencarcinoma, were included. The clinical, laboratory, and pathologic parameters were analyzed. A multivariate logistic regression model was used to determine the association. Moreover, for type of allergic drug, sub-group analysis was performed.Results469 patients were included, including 231 with pathological lymph node metastasis (pLNM) (49.3%) and 238 without pLNM. Univariate analysis showed, compared with patients without pLNM, patients with pLNM had a younger age (60.6±12.8 yr vs. 63.6±12.2 yr, P = 0.012), a lower percentage of drug allergy (8.7% vs. 16.0%, P = 0.016), an increased CEA (median/interquartile-range 5.40/2.40–13.95 vs. 3.50/2.08–8.67, P = 0.009), and a lower serum sodium (141±3.1 mmol/L vs. 142±2.9 mmol/L, P = 0.028). Multivariate analysis showed that drug allergy was associated with a reduced risk of pLNM (OR = 0.553; 95% CI, 0.308–0.994; P = 0.048). In addition, our results showed that: (1) for tumor classification, patients with drug allergy had a higher percentage of group patients with pT1/pT2; and (2) for type of allergic drug, this inverse association was found for penicillins, not for other allergic drugs.ConclusionDrug allergy is associated with a reduced risk of pLNM in rectal cancer.

Prostate Cancer Radiotherapy: Increased Biochemical Control and Late Toxicity in Men With Medication Allergies

“…Given that patients with MAs may have a decreased threshold to mount a T-cell response, the improved FFBF observed among patients with MAs could be explained by increased antitumor immune surveillance. This phenomenon has previously been implicated as a potential explanation for decreased risk of lymph node metastasis in rectal cancer patients with MAs ( 21 ) and improved cancer mortality in patients with asthma and hay fever ( 22 ). This decreased threshold to mount a T-cell–mediated response may also explain the observed difference in late toxicity following RT among patients with MAs.…”