Single dose of dexamethasone is not associated with postoperative recurrence and mortality in breast cancer patients: a propensity-matched cohort study
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 go...
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| Format: | Article |
| Language: | English |
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BMC
2019-03-01
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| Series: | BMC Cancer |
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| Online Access: | http://link.springer.com/article/10.1186/s12885-019-5451-5 |
| _version_ | 1818986621401300992 |
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| author | Myoung Hwa Kim Dong Wook Kim Seho Park Joo Heung Kim Ki Young Lee Jisung Hwang Young Chul Yoo |
| author_facet | Myoung Hwa Kim Dong Wook Kim Seho Park Joo Heung Kim Ki Young Lee Jisung Hwang Young Chul Yoo |
| author_sort | Myoung Hwa Kim |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-20T18:53:42Z |
| format | Article |
| id | doaj.art-d19bf653ca294a24a560fd65fa193840 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-20T18:53:42Z |
| publishDate | 2019-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-d19bf653ca294a24a560fd65fa1938402022-12-21T19:29:34ZengBMCBMC Cancer1471-24072019-03-0119111310.1186/s12885-019-5451-5Single dose of dexamethasone is not associated with postoperative recurrence and mortality in breast cancer patients: a propensity-matched cohort studyMyoung Hwa Kim0Dong Wook Kim1Seho Park2Joo Heung Kim3Ki Young Lee4Jisung Hwang5Young Chul Yoo6Department of Anaesthesiology and Pain Medicine, Severance Hospital, Anaesthesia and Pain Research Institute, Yonsei University College of MedicineDepartment of Policy Research Affairs, National Health Insurance Service Ilsan HospitalDivision of Breast Surgery, Department of Surgery, Yonsei University College of MedicineDepartment of Surgery, National Health Insurance service Ilsan hospitalDepartment of Anaesthesiology and Pain Medicine, Severance Hospital, Anaesthesia and Pain Research Institute, Yonsei University College of MedicineDepartment of Anaesthesiology and Pain Medicine, Severance Hospital, Anaesthesia and Pain Research Institute, Yonsei University College of MedicineDepartment of Anaesthesiology and Pain Medicine, Severance Hospital, Anaesthesia and Pain Research Institute, Yonsei University College of MedicineAbstract 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.http://link.springer.com/article/10.1186/s12885-019-5451-5DexamethasoneGlucocorticoidsBreast cancerRecurrenceMortalityImmunosuppression |
| spellingShingle | Myoung Hwa Kim Dong Wook Kim Seho Park Joo Heung Kim Ki Young Lee Jisung Hwang Young Chul Yoo Single dose of dexamethasone is not associated with postoperative recurrence and mortality in breast cancer patients: a propensity-matched cohort study BMC Cancer Dexamethasone Glucocorticoids Breast cancer Recurrence Mortality Immunosuppression |
| title | Single dose of dexamethasone is not associated with postoperative recurrence and mortality in breast cancer patients: a propensity-matched cohort study |
| title_full | Single dose of dexamethasone is not associated with postoperative recurrence and mortality in breast cancer patients: a propensity-matched cohort study |
| title_fullStr | Single dose of dexamethasone is not associated with postoperative recurrence and mortality in breast cancer patients: a propensity-matched cohort study |
| title_full_unstemmed | Single dose of dexamethasone is not associated with postoperative recurrence and mortality in breast cancer patients: a propensity-matched cohort study |
| title_short | Single dose of dexamethasone is not associated with postoperative recurrence and mortality in breast cancer patients: a propensity-matched cohort study |
| title_sort | single dose of dexamethasone is not associated with postoperative recurrence and mortality in breast cancer patients a propensity matched cohort study |
| topic | Dexamethasone Glucocorticoids Breast cancer Recurrence Mortality Immunosuppression |
| url | http://link.springer.com/article/10.1186/s12885-019-5451-5 |
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