Association of Low-Dose Aspirin and Survival of Women With Endometrial Cancer.

Abstract

OBJECTIVE:

To examine the survival outcomes in women with endometrial cancer who were taking low-dose aspirin (81-100 mg/d).

METHODS:

A multicenter retrospective study was conducted examining patients with stage I-IV endometrial cancer who underwent hysterectomy-based surgical staging between January 2000 and December 2013 (N=1,687). Patient demographics, medical comorbidities, medication types, tumor characteristics, and treatment patterns were correlated to survival outcomes. A Cox proportional hazard regression model was used to estimate adjusted hazard ratio for disease-free and disease-specific overall survival.

RESULTS:

One hundred fifty-eight patients (9.4%, 95% confidence interval [CI] 8.8-11.9) were taking low-dose aspirin. Median follow-up time for the study cohort was 31.5 months. One hundred twenty-seven patients (7.5%) died of endometrial cancer. Low-dose aspirin use was significantly correlated with concurrent obesity, hypertension, diabetes mellitus, and hypercholesterolemia (all P<.001). Low-dose aspirin users were more likely to take other antihypertensive, antiglycemic, and anticholesterol agents (all P<.05). Low-dose aspirin use was not associated with histologic subtype, tumor grade, nodal metastasis, or cancer stage (all P>.05). On multivariable analysis, low-dose aspirin use remained an independent prognostic factor associated with an improved 5-year disease-free survival rate (90.6% compared with 80.9%, adjusted hazard ratio 0.46, 95% CI 0.25-0.86, P=.014) and disease-specific overall survival rate (96.4% compared with 87.3%, adjusted hazard ratio 0.23, 95% CI 0.08-0.64, P=.005). The increased survival effect noted with low-dose aspirin use was greatest in patients whose age was younger than 60 years (5-year disease-free survival rates, 93.9% compared with 84.0%, P=.013), body mass index was 30 or greater (92.2% compared with 81.4%, P=.027), who had type I cancer (96.5% compared with 88.6%, P=.029), and who received postoperative whole pelvic radiotherapy (88.2% compared with 61.5%, P=.014). These four factors remained significant for disease-specific overall survival (all P<.05).

CONCLUSION:

Our results suggest that low-dose aspirin use is associated with improved survival outcomes in women with endometrial cancer, especially in those who are young, obese, with low-grade disease, and who receive postoperative radiotherapy.

• Authors: Koji Matsuo, Sigita S Cahoon, Kosuke Yoshihara, Masako Shida, Mamoru Kakuda, Sosuke Adachi, Aida Moeini, Hiroko Machida, Jocelyn Garcia-Sayre, Yutaka Ueda, Takayuki Enomoto, Mikio Mikami, Lynda D Roman, Anil K Sood
• Journal: Obstetrics and gynecology (Obstet Gynecol) Vol. 128 Issue 1 Pg. 127-137 (Jul 2016) ISSN: 1873-233X [Electronic] United States
• PMID: 27275802 (Publication Type: Journal Article, Multicenter Study)

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal
• Aspirin

Topics

• Adenocarcinoma (epidemiology, pathology, therapy)
• Aged
• Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
• Aspirin (therapeutic use)
• Comorbidity
• Diabetes Mellitus (epidemiology)
• Dose-Response Relationship, Drug
• Endometrial Neoplasms (epidemiology, pathology, therapy)
• Female
• Humans
• Hypercholesterolemia (epidemiology)
• Hypertension (epidemiology)
• Japan (epidemiology)
• Middle Aged
• Neoplasm Staging
• Obesity (epidemiology)
• Retrospective Studies
• Statistics as Topic
• Survival Analysis
• United States (epidemiology)