Intraoperative use of ketorolac or diclofenac is associated with improved disease-free survival and overall survival in conservative breast cancer surgery

P. Forget* (Corresponding Author), C. Bentin, J.-P. Machiels, M. Berliere, P.G. Coulie, M. De Kock

*Corresponding author for this work

Research output: Contribution to journalArticle

82 Citations (Scopus)

Abstract

Background. An association between the use of non-steroidal anti-inflammatory drugs (NSAIDs) and better outcome after mastectomy and lung surgery for cancer has been recently suggested. In a retrospective analysis, we investigated the association between intraoperative NSAIDs use in conservative breast cancer surgery and breast cancer disease-free survival (DFS). Similarly, we also evaluated the association between breast cancer DFS and preoperative neutrophil:lymphocyte ratio (NLR).
Methods. A retrospective analysis of a single-centre cohort was performed in breast cancer patients (n¼720) with uni- and multivariate analyses, using a Cox regression model.
Results. In conservative breast cancer surgery, the intraoperative use of NSAIDs
(ketorolac or diclofenac) was associated with an improved DFS {hazard ratio
(HR)¼0.57 [95% confidence interval (CI): 0.37–0.89], P¼0.01} and an improved
overall survival (OS) [HR¼0.35 (95% CI: 0.17–0.70), P¼0.03]. In these patients, an NLR. 3.3 (identified by a receiver-operating characteristic curve) was associated with a shorter DFS [HR¼1.99 (95% CI: 1.16–3.41), P¼0.01] and OS [HR¼2.35 (95% CI: 1.02– 5.43), P¼0.046].
Conclusions. Intraoperative NSAIDs and higher preoperative NLR are associated with improved outcome in conservative breast cancer surgery. Prospective, randomized trials to evaluate if these associations are causal are warranted.
Original languageEnglish
Pages (from-to)i82 - i87
Number of pages6
JournalBritish Journal of Anaesthesia
Volume113
Issue numberS1
Early online date25 Oct 2013
DOIs
Publication statusPublished - 2014

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