Prediagnosis aspirin use and outcomes in a prospective cohort of esophageal cancer patients

Araujo, James L.; Altorki, Nasser K.; Sonett, Joshua R.; Rodríguez, Adriana; Sungur-Stasik, Kivilcim; Spinelli, C; Neugut, Alfred I.; Abrams, Julian A.

doi:10.1177/1756283x16657985

Cited by 10 publications

(6 citation statements)

References 32 publications

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“…13 However this study did not contain any dose-response analyses, did not adjust for comorbidities, and was conducted in a very specific cancer subset (undergoing resection for esophageal squamous cell carcinoma or gastric cardia adenocarcinoma). Our findings are similar to a recent US study that investigated aspirin use before esophageal cancer in 130 patients with esophageal cancer, which found no association between medication use and cancer-specific mortality (HR, 1.07; 95% CI, 0.52-2.21) 30 ; however, their study did not investigate aspirin use after diagnosis and had limited power.…”

Section: Discussionsupporting

confidence: 87%

Low-Dose Aspirin Use Does Not Increase Survival in 2 Independent Population-Based Cohorts of Patients With Esophageal or Gastric Cancer

et al. 2018

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Section: Discussionsupporting

confidence: 87%

Low-Dose Aspirin Use Does Not Increase Survival in 2 Independent Population-Based Cohorts of Patients With Esophageal or Gastric Cancer

et al. 2018

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“…To address these issues, we investigated the effects of prediagnosis weight loss on outcomes in a prospective cohort of esophageal cancer patients that has previously been studied, and assessed whether these effects differed by tumor stage. 21…”

Section: Introductionmentioning

confidence: 99%

Variation by stage in the effects of prediagnosis weight loss on mortality in a prospective cohort of esophageal cancer patients

Shen

Araujo

Altorki

et al. 2017

Diseases of the Esophagus

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Cancer cachexia is increasingly recognized as a poor prognostic marker for various tumor types. Weight loss in esophageal cancer is multifactorial, as patients with bulky tumors also have reduced ability to eat. We aimed to investigate the relationship between prediagnosis weight loss and mortality in esophageal cancer and to determine whether these associations vary with tumor stage. We conducted a prospective cohort study of esophageal cancer patients at two tertiary centers. We recorded baseline patient characteristics including medications, smoking, body mass index, and weight loss in the year prior to diagnosis, and collected data on treatment and outcomes. We used Cox regression modeling to determine the associations between percent weight loss and outcomes. The main outcome of interest was all-cause mortality; secondary endpoints were esophageal cancer-specific mortality and development of metastases. We enrolled 134 subjects, the majority of whom had adenocarcinoma (82.1%); median percent weight loss was 4.7% (IQR: 0%-10.9%). Increasing percent weight loss was not associated with all-cause mortality (ptrend = 0.36). However, there was evidence of significant interaction by tumor stage (p = 0.02). There was a strong and significant association between prediagnosis weight loss and mortality in patients with T stages 1 or 2 (adjusted HR 8.26 for highest versus lowest tertile, 95%CI 1.11-61.5, ptrend = 0.03) but not for T stages 3 or 4 (ptrend = 0.32). Body mass index one year prior to diagnosis was not associated with mortality. Prediagnosis weight loss was associated with increased all-cause mortality only in patients with early stage esophageal cancer. This suggests that tumor-related cachexia can occur early in esophageal cancer and represents a poor prognostic marker.

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“…Araujo et al. 27 also concluded that taking aspirin before diagnosis was not related to all-cause or cancer-specific mortality in EC patients, but was related to an increased risk of metastasis.…”

Section: Discussionmentioning

confidence: 99%

Effect of taking aspirin before diagnosis on the prognosis of esophageal squamous cell carcinoma and analysis of prognostic factors

Jiang¹,

Liu

Gao

et al. 2022

J Int Med Res

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Objective The 5-year survival rate of patients with esophageal squamous cell cancer (ESCC) is very low. However, long-term aspirin use has been suggested to have an adjuvant therapeutic effect. We therefore investigated the effect of long-term aspirin use before ESCC diagnosis on postoperative patient survival. Methods We carried out a retrospective cohort study of patients who underwent esophageal cancer resection in our hospital from 2008 to 2018. Patients were divided into an aspirin group (n = 79) and control group (n = 79), and were followed up until December 2019. We analyzed the clinicopathological and follow-up data of the patients during hospitalization, and the cyclooxygenase-2 (COX-2) protein expression levels by immunohistochemistry, and related these to postoperative survival. Results Patients who took aspirin had significantly lower survival rates than those who did not. COX-2-negative patients had better survival than patients with either low or high COX-2 expression levels. T stage was the only independent predictor of survival in patients who took aspirin. Conclusions Long-term regular use of aspirin before diagnosis had an adverse effect on postoperative survival in patients with ESCC. Different COX-2 protein expression levels were associated with significantly different postoperative survival rates, with COX-2-positive patients having the poorest survival.

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Prediagnosis aspirin use and outcomes in a prospective cohort of esophageal cancer patients

Cited by 10 publications

References 32 publications

Low-Dose Aspirin Use Does Not Increase Survival in 2 Independent Population-Based Cohorts of Patients With Esophageal or Gastric Cancer

Low-Dose Aspirin Use Does Not Increase Survival in 2 Independent Population-Based Cohorts of Patients With Esophageal or Gastric Cancer

Variation by stage in the effects of prediagnosis weight loss on mortality in a prospective cohort of esophageal cancer patients

Effect of taking aspirin before diagnosis on the prognosis of esophageal squamous cell carcinoma and analysis of prognostic factors

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