Evaluation of beta-blockers and survival among hypertensive patients with renal cell carcinoma

• Published in: Urologic oncology 2017-01, Vol.35 (1), p.36.e1-36.e6
• Main Authors: Parker, William P., M.D, Lohse, Christine M., M.S, Zaid, Harras B., M.D, Cheville, John C., M.D, Boorjian, Stephen A., M.D, Leibovich, Bradley C., M.D, Thompson, R. Houston, M.D
• Format: Article
• Language: English
• Subjects: Adrenergic beta-Antagonists - therapeutic use; Aged; Antihypertensive Agents - therapeutic use; Beta-blocker; Carcinoma, Renal Cell - complications; Carcinoma, Renal Cell - mortality; Carcinoma, Renal Cell - surgery; Cause of Death; Disease Progression; Disease-Free Survival; Female; Follow-Up Studies; Humans; Hypertension; Hypertension - complications; Hypertension - drug therapy; Kidney Neoplasms - complications; Kidney Neoplasms - mortality; Kidney Neoplasms - surgery; Male; Middle Aged; Nephrectomy; Proportional Hazards Models; Renal cell carcinoma; Retrospective Studies; Survival; Survival Rate; United States - epidemiology; Urology
• ISSN: 1078-1439; 1873-2496
• DOI: 10.1016/j.urolonc.2016.08.013

Abstract Objectives Beta-blocker use is associated with improved survival for multiple nonurologic malignancies. Our objective was to evaluate the association between beta-blocker use and survival among surgically managed hypertensive patients with clear-cell renal cell carcinoma (ccRCC). Methods Hypertensive patients with ccRCC treated with either radical or partial nephrectomy between 2000 and 2010 were identified from our Nephrectomy Registry. Beta-blocker use within 90 days before surgery was identified. The associations between beta-blocker use and risk of disease progression, death from renal cell carcinoma (RCC), and all-cause mortality were assessed using Cox proportional hazards regression models. Results In total, 913 hypertensive patients were identified who underwent either partial or radical nephrectomy for ccRCC. Of these, 104 (11%) had documented beta-blocker use within 90 days before surgery. At last follow-up (median 8.2 y among survivors), 258 patients showed progression (median 1.6 y following surgery), and 369 patients had died (median 4.1 y following surgery), including 138 who died of RCC. After adjusting for PROG (progression-free survival) and SSIGN (cancer-specific survival) scores, beta-blocker use was not significantly associated with the risk of disease progression (hazard ratio [HR] = 0.94; 95% CI: 0.61–1.47; P = 0.80) or the risk of death from RCC (HR = 0.74; 95% CI: 0.38–1.41; P = 0.35). Similarly, on multivariable analysis adjusting for clinicopathologic features, there was not a significant association between beta-blocker use and the risk of all-cause mortality (HR = 0.83; 95% CI: 0.59–1.16; P = 0.27). Conclusions Beta-blocker use for hypertension within 90 days before surgery was not associated with the risk of progression, death from RCC, or death from any cause.