Single dose of dexamethasone is not associated with postoperative recurrence and mortality in breast cancer patients: a propensity-matched cohort study

BMC Cancer

Young Chul Yoo¹  Ki Young Lee¹  Jisung Hwang¹  Myoung Hwa Kim¹  Dong Wook Kim²  Joo Heung Kim³  Seho Park⁴ 

[1] Department of Anaesthesiology and Pain Medicine, Severance Hospital, Anaesthesia and Pain Research Institute, Yonsei University College of Medicine;Department of Policy Research Affairs, National Health Insurance Service Ilsan Hospital;Department of Surgery, National Health Insurance service Ilsan hospital;Division of Breast Surgery, Department of Surgery, Yonsei University College of Medicine;

关键词: Dexamethasone;    Glucocorticoids;    Breast cancer;    Recurrence;    Mortality;    Immunosuppression;   

DOI  :  10.1186/s12885-019-5451-5

来源: DOAJ

【 摘 要 】

Abstract Background Dexamethasone is widely used in cancer patients despite the concern that perioperative glucocorticoids may potentially cause immunosuppression. However, studies on the influence of dexamethasone on cancer recurrence after curative surgery have produced conflicting results. The goal of our study was to compare postoperative recurrence-free survival and overall survival between patients with breast cancer who received perioperative dexamethasone and those who did not. Methods The medical records of 2729 patients who underwent breast cancer surgery between November 2005 and December 2010 were reviewed. These patients were followed up until December 2015. The patients were categorised according whether they received a single dose of intravenous dexamethasone perioperatively or not. Cox regression analyses were conducted to evaluate any associations between dexamethasone usage with postoperative recurrence and mortality. Additionally, we performed a sensitivity test with propensity score matching to adjust for selection bias. Results Among the 2628 patients, 236 (8.5%) received perioperative dexamethasone. No increasing risk for recurrence (hazard ratio [HR], 1.442; 95% confidence interval [CI], 0.969–2.145; P = 0.071) or mortality (HR, 1.256; 95% CI, 0.770–2.047; P = 0.361) after breast cancer surgery were identified in patients who received dexamethasone. Similarly, propensity score matching did not show significant associations in postoperative recurrence (HR, 1.389; 95% CI, 0.904–2.132; P = 0.133) or mortality (HR, 1.506; 95% CI, 0.886–2.561; P = 0.130) in patients who received dexamethasone. Conclusions We found that a perioperative single dose of dexamethasone is not associated with increased recurrence or mortality after curative surgery in breast cancer patients.

【 授权许可】

Unknown