Postoperative Impact of Anti‐Inflammatory Drug on Cancer Recurrence in Patients With Locally Advanced Gastric Cancer After Curative Gastrectomy: A Pilot Retrospective Study

TL;DR

This study explores whether anti-inflammatory drugs after surgery for advanced gastric cancer can reduce cancer recurrence.

Contribution

The study investigates the novel use of anti-inflammatory drugs post-surgery to improve recurrence-free survival in gastric cancer patients.

Findings

Anti-inflammatory drugs were associated with lower peritoneal recurrence rates in gastric cancer patients.

Multivariate analysis showed anti-inflammatory drugs as independent prognostic factors for recurrence-free survival.

The drugs were more effective in pStage III patients compared to pStage II patients.

Abstract

Elevated postoperative inflammation is associated with reduced recurrence‐free survival (RFS) after gastrectomy in patients with gastric cancer, independent of postoperative complications. The effect of the administration of anti‐inflammatory drugs immediately after gastrectomy on prolonging RFS in patients with gastric cancer has not been fully investigated. In this study, we aimed to investigate the effects of anti‐inflammatory drugs on the long‐term recurrence rates of gastric cancer after radical resection.

This retrospective cohort study included consecutive patients who underwent radical gastrectomy for primary pStage II–III gastric cancer between May 2006 and March 2017. We performed propensity score matching using a logistic regression model to adjust for patient background, compared RFS, and used Cox proportional hazard regression to identify prognostic factors.

Median duration of follow‐up was 62 months. After matching, 591 patients were included in the untreated group, and 197 were included in the group treated with anti‐inflammatory drugs. RFS was no significant difference in the two groups (5‐year RFS: treated group, 73.2%; untreated group, 68.4%; p = 0.246), but peritoneal recurrence was significantly lower in the treated group (p = 0.028). Multivariate analyses showed that anti‐inflammatory drugs were independent prognostic factors for recurrence‐free survival (hazard ratio, 0.751; 95% confidence interval, 0.569–0.992; p = 0.044). In the subgroup analysis, using multivariate analysis for recurrence‐free survival, anti‐inflammatory drugs were more effective in patients with pStage III than in those with pStage II disease.

Anti‐inflammatory drug administration after radical resection may prolong recurrence‐free survival in patients with pStage III gastric cancer.

Anti‐inflammatory drugs may be effective in improving recurrence‐free survival after radical gastrectomy in patients with pStage II or III gastric cancer.

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