International Journal of Clinical Oncology

, Volume 23, Issue 1, pp 52–58 | Cite as

Aspirin use and head and neck cancer survival: an observational study of 11,623 person-years follow-up

  • Shin-Ae Kim
  • Jong-Lyel Roh
  • Sung-Bae Kim
  • Seung-Ho Choi
  • Soon Yuhl Nam
  • Sang Yoon Kim
Original Article
  • 146 Downloads

Abstract

Background

Acetylsalicylic acid (aspirin) and non-steroidal anti-inflammatory drugs (NSAIDs) have been associated with reduced risks for certain human cancers. However, the effects of aspirin and NSAIDs on head and neck squamous cell carcinoma (HNSCC) remain controversial, and the prognostic effects of these drugs in patients with HNSCC are largely unknown. This study examined the clinical impact of aspirin and NSAIDs on disease recurrence and survival in patients with HNSCC.

Methods

This study analysed a cohort of 1392 consecutive patients who received definitive treatment for previously untreated HNSCC at our tertiary referral center. Aspirin or NSAID use was considered positive if the patients were receiving aspirin or NSAID medication from HNSCC diagnosis to at least 1 year after treatment initiation. Cox proportional hazard models were utilised to determine the association of aspirin and/or NSAID use with recurrence, survival, and second primary cancer occurrence.

Results

Of 1392 patients, 81 (5.8%) and 89 (6.4%) received post-diagnosis treatment with aspirin and NSAIDs, respectively. After controlling for clinical factors, aspirin and NSAIDs were not significantly associated with recurrence, survival, or second cancer occurrence (P > 0.05). The cumulative dose of aspirin or NSAIDs did not alter survival outcomes (P > 0.05).

Conclusion

Our data illustrated that the use of aspirin or NSAIDs has no effect on survival or recurrence in patients with HNSCC.

Keywords

Head and neck squamous cell carcinoma Aspirin Non-steroidal anti-inflammatory drug Survival Recurrence 

Notes

Acknowledgements

This study was supported by a Grant (No. 2015R1A2A1A15054540) from Basic Science Research Program through the National Research Foundation of Korea (NRF), Ministry of Science, ICT, and Future Planning, and a Grant (No. HI15C2920) from the Korean Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), Ministry of Health & Welfare, Seoul, Republic of Korea (J.-L. Roh).

Compliance with ethical standards

Conflict of interest

The authors have no conflict of interest to declare.

References

  1. 1.
    Carvalho AL, Nishimoto IN, Califano JA et al (2005) Trends in incidence and prognosis for head and neck cancer in the United States: a site-specific analysis of the SEER database. Int J Cancer 114(5):806–816CrossRefPubMedGoogle Scholar
  2. 2.
    Suh JD, Cho JH (2016) Trends in head and neck cancer in South Korea between 1999 and 2012. Clin Exp Otorhinolaryngol 9(3):263–269. doi: 10.21053/ceo.2015.01123 CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Chan G, Boyle JO, Yang EK et al (1999) Cyclooxygenase-2 expression is up-regulated in squamous cell carcinoma of the head and neck. Cancer Res 59(5):991–994PubMedGoogle Scholar
  4. 4.
    Lupulescu A (1996) Prostaglandins, their inhibitors and cancer. Prostaglandins Leukot Essent Fatty Acids 54(2):83–94CrossRefPubMedGoogle Scholar
  5. 5.
    Jung TT, Berlinger NT, Juhn S (1985) Prostaglandins in squamous cell carcinoma of the head and neck: a preliminary study. Laryngoscope 95(3):307–312CrossRefPubMedGoogle Scholar
  6. 6.
    Dannenberg AJ, Subbaramaiah K (2003) Targeting cyclooxygenase-2 in human neoplasia: rationale and promise. Cancer Cell 4(6):431–436CrossRefPubMedGoogle Scholar
  7. 7.
    Rigas B, Goldman IS, Levine L (1993) Altered eicosanoid levels in human colon cancer. J Lab Clin Med 122(5):518–523PubMedGoogle Scholar
  8. 8.
    Flossmann E, Rothwell PM (2007) Effect of aspirin on long-term risk of colorectal cancer: consistent evidence from randomised and observational studies. Lancet 369(9573):1603–1613CrossRefPubMedGoogle Scholar
  9. 9.
    Corley DA, Kerlikowske K, Verma R et al (2003) Protective association of aspirin/NSAIDs and esophageal cancer: a systematic review and meta-analysis. Gastroenterology 124(1):47–56CrossRefPubMedGoogle Scholar
  10. 10.
    Lin DT, Subbaramaiah K, Shah JP et al (2002) Cyclooxygenase-2: a novel molecular target for the prevention and treatment of head and neck cancer. Head Neck 24(8):792–799CrossRefPubMedGoogle Scholar
  11. 11.
    Chan AT, Ogino S, Fuchs CS (2009) Aspirin use and survival after diagnosis of colorectal cancer. JAMA 302(6):649–658CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Holmes MD, Chen WY, Li L et al (2010) Aspirin intake and survival after breast cancer. J Clin Oncol 28(9):1467–1472CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Creagan ET, Twito DI, Johansson SL et al (1991) A randomized prospective assessment of recombinant leukocyte A human interferon with or without aspirin in advanced renal adenocarcinoma. J Clin Oncol 9(12):2104–2109CrossRefPubMedGoogle Scholar
  14. 14.
    Lipton A, Scialla S, Harvey H et al (1981) Adjuvant antiplatelet therapy with aspirin in colo-rectal cancer. J Med 13(5–6):419–429Google Scholar
  15. 15.
    Wilson JC, Anderson LA, Murray LJ et al (2011) Non-steroidal anti-inflammatory drug and aspirin use and the risk of head and neck cancer: a systematic review. Cancer Causes Control 22(5):803–810CrossRefPubMedGoogle Scholar
  16. 16.
    Denaro N, Merlano MC, Russi EG (2016) Follow-up in head and neck cancer: do more does it mean do better? A systematic review and our proposal based on our experience. Clin Exp Otorhinolaryngol . doi: 10.21053/ceo.2015.00976 PubMedPubMedCentralGoogle Scholar
  17. 17.
    Kim S, Roh JL, Lee SA et al (2016) Pretreatment depression as a prognostic indicator of survival and nutritional status in patients with head and neck cancer. Cancer 122(1):131–140CrossRefPubMedGoogle Scholar
  18. 18.
    Karimi E, Ardestani SH, Jafari M et al (2016) Testing a new anticoagulation method for free flap reconstruction of head and neck cancers. Clin Exp Otorhinolaryngol. doi: 10.21053/ceo.2015.01781 PubMedPubMedCentralGoogle Scholar
  19. 19.
    Antoni MH, Lutgendorf SK, Cole SW et al (2006) The influence of bio-behavioural factors on tumour biology: pathways and mechanisms. Nat Rev Cancer 6(3):240–248CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Simmons DL, Botting RM, Hla T (2004) Cyclooxygenase isozymes: the biology of prostaglandin synthesis and inhibition. Pharmacol Rev 56(3):387–437CrossRefPubMedGoogle Scholar
  21. 21.
    Jayaprakash V, Rigual NR, Moysich KB et al (2006) Chemoprevention of head and neck cancer with aspirin: a case-control study. Arch Otolaryngol Head Neck Surg 132(11):1231–1236CrossRefPubMedGoogle Scholar
  22. 22.
    Kang SU, Shin YS, Hwang HS et al (2012) Tolfenamic acid induces apoptosis and growth inhibition in head and neck cancer: involvement of NAG-1 expression. PLoS One 7(4):e34988CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Thurnher D, Bakroeva M, Formanek M et al (2001) Non-steroidal anti-inflammatory drugs inhibit telomerase activity in head and neck squamous carcinoma cell lines. Head Neck 23(12):1049–1055CrossRefPubMedGoogle Scholar
  24. 24.
    Hashitani S, Urade M, Nishimura N et al (2003) Apoptosis induction and enhancement of cytotoxicity of anticancer drugs by celecoxib, a selective cyclooxygenase-2 inhibitor, in human head and neck carcinoma cell lines. Int J Oncol 23(3):665–672PubMedGoogle Scholar
  25. 25.
    Thurnher MB, Schütz Gertraud, Pelzmann Martina et al (2001) Non-steroidal anti-inflammatory drugs induce apoptosis in head and neck cancer cell lines. Acta Otolaryngol 121(8):957–962CrossRefPubMedGoogle Scholar
  26. 26.
    Wirth LJ, Haddad RI, Lindeman NI et al (2005) Phase I study of gefitinib plus celecoxib in recurrent or metastatic squamous cell carcinoma of the head and neck. J Clin Oncol 23(28):6976–6981CrossRefPubMedGoogle Scholar
  27. 27.
    Bastiaannet E, Sampieri K, Dekkers O et al (2012) Use of aspirin postdiagnosis improves survival for colon cancer patients. Br J Cancer 106(9):1564–1570CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Din FV, Theodoratou E, Farrington SM et al (2010) Effect of aspirin and NSAIDs on risk and survival from colorectal cancer. Gut 59(12):1670–1679CrossRefPubMedGoogle Scholar
  29. 29.
    Liao X, Lochhead P, Nishihara R et al (2012) Aspirin use, tumor PIK3CA mutation, and colorectal-cancer survival. N Engl J Med 367(17):1596–1606CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Lebeau B, Chastang C, Muir J et al (1993) No effect of an antiaggregant treatment with aspirin in small cell lung cancer treated with CCAVP16 chemotherapy results from a randomized clinical trial of 303 patients. Cancer 71(5):1741–1745CrossRefPubMedGoogle Scholar
  31. 31.
    Ridker PM, Cook NR, Lee I-M et al (2005) A randomized trial of low-dose aspirin in the primary prevention of cardiovascular disease in women. N Engl J Med 352(13):1293–1304CrossRefPubMedGoogle Scholar
  32. 32.
    Sturmer T, Glynn RJ, Lee I-M et al (1998) Aspirin use and colorectal cancer: post-trial follow-up data from the physicians’ health study. Ann Intern Med 128(9):713–720CrossRefPubMedGoogle Scholar
  33. 33.
    Chan AT, Giovannucci EL, Meyerhardt JA et al (2008) Aspirin dose and duration of use and risk of colorectal cancer in men. Gastroenterology 134(1):21–28CrossRefPubMedGoogle Scholar

Copyright information

© Japan Society of Clinical Oncology 2017

Authors and Affiliations

  1. 1.Department of Otolaryngology, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
  2. 2.Department of Internal Medicine (Oncology), Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea

Personalised recommendations