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A Preliminary Study on the Postoperative Survival of Patients Given Aspirin After Resection for Squamous Cell Carcinoma of the Esophagus or Adenocarcinoma of the Cardia

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

We examined the effect of aspirin on survival following resection for squamous cell carcinoma (SCC) of the esophagus or adenocarcinoma of the gastric cardia.

Methods

Patients who underwent esophagectomy for these cancers between May 2000 and December 2002 were allocated to one of three groups and given daily either a low dose of aspirin, placebo, or no tablets.

Results

The 5-year survival for all patients on aspirin (445) was 51.2%, placebo (658) 41%, and no tablet (495) 42.3% (P = 0.04 for difference between treatments). The 5-year survival for all SCC patients on aspirin (267) was 49.8%, placebo (433) 42.2%, and no tablet (343) 41.2% (P = 0.26). There was a significant improvement in survival for patients with adenocarcinoma of the cardia on aspirin compared with the two control groups combined (P = 0.029). Survival for T2N0M0 SCC patients was significantly improved with aspirin (71) compared with placebo (167) or no tablet (134) (P = 0.0004). However, there was no significant difference between the survival curves for T2N0M0 adenocarcinoma patients on aspirin (21) and the two control groups combined (65) (P = 0.29).

Conclusions

The results of this preliminary study support further investigation of aspirin as adjuvant therapy to improve survival in subsets of postesophagectomy patients.

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References

  1. Li H, Yao SC. Surgical treatment for carcinoma of the oesophagus in Chinese language publications. Br J Surg. 1997;84:855–7.

    Article  PubMed  CAS  Google Scholar 

  2. Liu JF, Wang QZ, Hou J. Surgical treatment for cancer of the oesophagus and gastric cardia in Hebei, China. Br J Surg. 2004;91:90–8.

    Article  PubMed  CAS  Google Scholar 

  3. Burmeister DH, Smithers BM, MStat VG, Fitzgerald L, Simes RJ, Devitt P, et al. Surgery alone versus chemoradiotherapy followed by surgery for resectable cancer of the oesophagus: a randomised controlled phase III trial. Lancet Oncol. 2005;6:659–68.

    Article  PubMed  Google Scholar 

  4. Das P, Fukami N, Ajani JA. Combined modality therapy of localized gastric and esophageal cancers. JNCCN. 2006;4:375–82.

    PubMed  CAS  Google Scholar 

  5. Gebski V, Burmeister B, Smithers BM, Foo K, Zalcberg J, Simes J, et al. Survival benefits from neoadjuvant chemoradiotherapy or chemotherapy in oesophageal carcinoma: a meta-analysis. Lancet Oncol. 2007;8:226–34.

    Article  PubMed  CAS  Google Scholar 

  6. Liu JF, Jamieson GG, Drew PA, Zhu GJ, Zhang SW, Zhu TN, et al. Aspirin induces apoptosis in oesophageal cancer cells by inhibiting the pathway of NF-kappa B downstream regulation of cyclooxygenase-2. ANZ J Surg. 2005;75:1011–6.

    Article  PubMed  Google Scholar 

  7. Liu JF, Zhang SW, Jamieson GG, Zhu GJ, Wu TC, Zhu TN, et al. The effects of a COX-2 inhibitor meloxicam on squamous cell carcinoma of the esophagus in vivo. Int J Cancer. 2008;122:1639–44.

    Article  PubMed  CAS  Google Scholar 

  8. Liu JF, Jamieson GG, Wu TC, Zhang SW, Wang QZ, Drew PA. Cyclooxygenase-2 expression in squamous cell carcinoma of the esophagus. Dis Esoph. 2006;19:350–4.

    Article  Google Scholar 

  9. Li M, Wu X, Xu XC. Induction of apoptosis by cyclo-oxygenase-2 inhibitor NS398 through a cytochrome C-dependent pathway in esophageal cancer cells. Int J Cancer. 2001;93:218–23.

    Article  PubMed  CAS  Google Scholar 

  10. Langman MJ, Cheng KK, Gilman EA, Lancashire RJ. Effect of anti-inflammatory drugs on overall risk of common cancer: case-control study in general practice research database. BMJ. 2000;320:1642–6.

    Article  PubMed  CAS  Google Scholar 

  11. Funkhouser EM, Sharp GB. Aspirin and reduced risk of esophageal carcinoma. Cancer. 1995;76:1116–9.

    Article  PubMed  CAS  Google Scholar 

  12. Thun MJ, Heath CW. Aspirin use and reduced risk of gastrointestinal tract cancers in the American Cancer Society prospective studies. Prev Med. 1995;24:116–8.

    Article  PubMed  CAS  Google Scholar 

  13. Barbier PA, Becker CD, Wagner HE. Esophageal carcinoma: patient selection for transhiatal esophagectomy, A prospective analysis of 50 consecutive cases, World J Surg. 1988;12:263–9.

    Article  PubMed  CAS  Google Scholar 

  14. De Manzoni G, Pedrazzani C, Pasini F, Durante E, Gabbani M, Grandinetti A, et al. Pattern of recurrence after surgery in adenocarcinoma of the gastro-oesophageal junction. EJSO. 2003;29:506–10.

    Article  PubMed  Google Scholar 

  15. Nakagawa S, Kanda T, Kosugi SI, Ohashi M, Suzuki T, Hatakeyama K. Recurrence pattern of squamous cell carcinoma of the thoracic esophagus after extended radical esophagectomy with three-field lymphadenectomy. J Am Coll Surg. 2004;198:205–11.

    Article  PubMed  Google Scholar 

  16. Natsugoe S, Okumura H, Matsumoto M, Uchikado Y, Setoyama T, Yokomakura N, et al. Randomized controlled study on preoperative chemoradiotherapy followed by surgery versus surgery alone for esophageal squamous cell cancer in a single institution. Dis Esoph. 2006;19:468–72.

    Article  CAS  Google Scholar 

  17. Malthaner RA, Wong RK, Rumble RB, Zuraw L;Members of the Gastrointestinal Cancer Disease Site Group of Cancer Care Ontario’s Program in Evidence-based Care. Neoadjuvant or adjuvant therapy for resectable esophageal cancer: a systematic review and meta-analysis. BMC Med. 2004;2:35–51.

    Article  PubMed  Google Scholar 

  18. Dubé C, Rostom A, Lewin G, Tsertsvadze A, Barrowman N, Code C, et al. The use of aspirin for primary prevention of colorectal cancer: a systematic review prepared for the U.S. Preventive Services Task Force. Ann Intern Med. 2007;146:365–75.

    PubMed  Google Scholar 

  19. Futakuchi M, Ogawa K, Tamano S, Takahashi S, Shirai T. Suppression of metastasis by nuclear factor kappaB inhibitors in an in vivo lung metastasis model of chemically induced hepatocellular carcinoma. Cancer Sci. 2004;95:18–24.

    Article  PubMed  CAS  Google Scholar 

  20. Backhus LM, Sievers E, Lin GY, Castanos R, Bart RD, Starnes VA, et al. Perioperative cyclooxygenase 2 inhibition to reduce tumor cell adhesion and metastatic potential of circulating tumor cells in non-small cell lung cancer. J Thorac Cardiovasc Surg. 2006;132:297–303.

    Article  PubMed  CAS  Google Scholar 

  21. Qadri SS, Wang JH, Coffey JC, Alam M, O’Donnell A, Aherne T, et al. Can surgery for cancer accelerate the progression of secondary tumors within residual minimal disease at both local and systemic levels? Ann Thorac Surg. 2005;80:1046–50.

    Article  PubMed  Google Scholar 

  22. Awara WM, El-Sisi AE, El-Sayad ME, Goda AE. The potential role of cyclooxygenase-2 inhibitors in the treatment of experimentally-induced mammary tumor: does celecoxib enhance the anti-tumor activity of doxorubicin? Pharmacol Res. 2004;50:487–98.

    Article  PubMed  CAS  Google Scholar 

  23. Duffy CP, Elliott CJ, O’Connor RA, Heenan MM, Coyle S, Cleary IM, et al. Enhancement of chemotherapeutic drug toxicity to human tumor cells in vitro by a subset of non-steroidal anti-inflammatory drugs (NSAIDs). Eur J Cancer. 1998;34:1250–9.

    Article  PubMed  CAS  Google Scholar 

  24. Kobayashi S, Okada S, Yoshida H, Fujimura S. Indomethacin enhances the cytotoxicity of VCR and ADR in human pulmonary adenocarcinoma cells. Tohoku J Exp Med. 1997;181:361–70.

    Article  PubMed  CAS  Google Scholar 

  25. Hida T, Leyton J, Makheja AN, Ben-Av P, Hla T, Martinez A, et al. Non-small cell lung cancer cycloxygenase activity and proliferation are inhibited by non-steroidal antiinflammatory drugs. Anticancer Res. 1998;18:775–82.

    PubMed  CAS  Google Scholar 

  26. Mizutani Y, Kamoi K, Ukimura O, Kawauchi A, Miki T. Synergistic cytotoxicity and apoptosis of JTE-522, a selective cyclooxygenase-2 inhibitor, and 5-fluorouracil against bladder cancer. J Urol. 2002;168:2650–4.

    Article  PubMed  CAS  Google Scholar 

  27. Petersen C, Petersen S, Milas L, Lang FF, Tofilon PJ. Enhancement of intrinsic tumor cell radiosensitivity induced by a selective cyclooxygenase-2 inhibitor. Clin Cancer Res. 2000;6:2513–20.

    PubMed  CAS  Google Scholar 

  28. Pyo H, Choy H, Amorino GP, Kim JS, Cao Q, Hercules SK, et al. A selective cyclooxygenase-2 inhibitor, NS-398, enhances the effect of radiation in vitro and in vivo preferentially on the cells that express cyclooxygenase-2. Clin Cancer Res. 2001;7:2998–3005.

    PubMed  CAS  Google Scholar 

  29. Raju U, Nakata E, Yang P, Newman RA, Ang KK, Milas L. In vitro enhancement of tumor cell radiosensitivity by a selective inhibitor of cyclooxygenase-2 enzyme: mechanistic considerations. Int J Radiat Oncol Biol Phys. 2002;54:886–94.

    PubMed  CAS  Google Scholar 

  30. Giovannucci E, Egan KM, Hunter DJ, Stampfer MJ, Colditz GA, Willett WC, et al. Aspirin and the risk of colorectal cancer in women. N Engl J Med. 1995;333:609–14.

    Article  PubMed  CAS  Google Scholar 

  31. Thun MJ, Heath CW. Aspirin use and reduced risk of gastrointestinal tract cancers in the American Cancer Society prospective studies. Prev Med. 1995;24:116–8.

    Article  PubMed  CAS  Google Scholar 

  32. Collet JP, Sharpe C, Belzile E, Boivin JF, Hanley J, Abenhaim L. Colorectal cancer prevention by non-steroidal anti-inflammatory drugs: effects of dosage and timing. Br J Cancer. 1999;81:62–8.

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

This project was funded by Hebei Provincial Natural Science Foundation, China and Wakefield Hospital, Adelaide, Australia. Dr. T.C. Wu is currently working in Handan City Hospital, China.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Fourth Hospital, Hebei Medical University, 12 Jiankang Road, Shijiazhuang, China

    Jun-Feng Liu MD, PhD, Tie-Cheng Wu MMed & Gui-Jun Zhu MD

  2. University Department of Surgery, Royal Adelaide Hospital, Adelaide, Australia

    Glyn G. Jamieson MS, FRACS

  3. School of Nursing and Midwifery, Flinders University, Adelaide, Australia

    Paul A. Drew PhD

Authors
  1. Jun-Feng Liu MD, PhD
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  2. Glyn G. Jamieson MS, FRACS
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  3. Tie-Cheng Wu MMed
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  4. Gui-Jun Zhu MD
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  5. Paul A. Drew PhD
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Corresponding author

Correspondence to Jun-Feng Liu MD, PhD.

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Liu, JF., Jamieson, G.G., Wu, TC. et al. A Preliminary Study on the Postoperative Survival of Patients Given Aspirin After Resection for Squamous Cell Carcinoma of the Esophagus or Adenocarcinoma of the Cardia. Ann Surg Oncol 16, 1397–1402 (2009). https://doi.org/10.1245/s10434-009-0382-z

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  • DOI: https://doi.org/10.1245/s10434-009-0382-z

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