The use of non-steroid anti-inflammatory drugs during radical resection correlated with the outcome in non-small cell lung cancer

• Published in: World journal of surgical oncology 2023-11, Vol.21 (1), p.1-358, Article 358
• Main Authors: Cai, Renzhong, Liao, Xuqiang, Li, Gao, Xiang, Jia, Ye, Qianwen, Chen, Minbiao, Feng, Shouhan
• Format: Article
• Language: English
• Subjects: Analysis; Anti-inflammatory agents; Anti-inflammatory drugs; Aspirin; Complications and side effects; Correlation; Data collection; Disease-free survival; Drug dosages; Drug therapy; Drugs; Immunotherapy; Inflammation; Lung cancer; Lung cancer, Non-small cell; Lung cancer, Small cell; Metastasis; Non-small cell lung carcinoma; Non-steroid anti-inflammatory drugs; Nonsteroidal anti-inflammatory drugs; Ostomy; Overall survival; Pain; Patient outcomes; Patients; Prognosis; Risk analysis; Risk factors; Small cell lung carcinoma; Sodium; Statistical models; Steroids; Subgroups; Surgery; Survival
• ISSN: 1477-7819; 1477-7819
• DOI: 10.1186/s12957-023-03247-8

Aims The use of non-steroid anti-inflammatory drugs (NSAIDs) is conventional in management of postoperative pain in cancer patients, and further investigations have reported that some of these drugs correlated with the outcome in cancers. However, the prognostic value of the use of NSAIDs during surgery in non-small cell lung cancer (NSCLC) patients has been less addressed. Methods NSCLC patients staged I-III are retrospectively enrolled, and the data of the use of NSAIDs during surgery are collected. Patients are divided into two subgroups according to the use intensity (UI) (low or high) of the NSAIDs, which was calculated by the accumulate dosage of all the NSAIDs divided by the length of hospitalization. The differences of the clinical features among these groups were checked. And the disease-free survival (DFS) and overall survival (OS) differences in these groups were compared by Kaplan-Meier analysis; risk factors for survival were validated by using a Cox proportional hazards model. Results The UI was significant in predicting the DFS (AUC = 0.65, 95% CI: 0.57-0.73, P = 0.001) and OS (AUC = 0.70, 95% CI: 0.59-0.81, P = 0.001). Clinical features including type of resection (P = 0.001), N stages (P < 0.001), and TNM stages (P = 0.004) were significantly different in UI low (< 74.55 mg/day) or high ([greater than or equal to] 74.55 mg/day) subgroups. Patients in UI-high subgroups displayed significant superior DFS (log rank = 11.46, P = 0.001) and OS (log rank = 7.63, P = 0.006) than the UI-low ones. At last, the UI was found to be an independent risk factor for DFS (HR: 0.52, 95% CI: 0.28-0.95, P = 0.034). Conclusions The use of NSAIDs during radical resection in NSCLC patients correlated with the outcome and patients with a relative high UI has better outcome. Keywords: Lung cancer, Non-steroid anti-inflammatory drugs, Surgery, Disease-free survival, Overall survival