Abstract

Abstract Background Esophageal squamous cell carcinoma (ESCC), prevalent globally, especially in Asia, is primarily treated with esophagectomy. Concurrently, hypertension, managed often with calcium channel blockers (CCBs), is widespread. The influence of CCBs on post-esophagectomy outcomes in hypertensive ESCC patients is yet to be fully understood. This study seeks to elucidate CCBs' impact on these patients to improve clinical management and drug selection. Methods Patients who underwent esophagectomy between December 2008 and Nov 2022 were extracted from a 4-centre prospectively maintained database, and those with hypertension were categorized based on whether they have been taking CCBs for an extended period (more than 1 year). Survival was analyzed using the log-rank test and multivariable Cox regression analysis. Results Of the 7954 esophagectomies, 348 cases of hypertensive ESCC patients were eligible. 37% (129 out of 348) of the patients with hypertensive ESCC patients had been on long-term CCB therapy. In univariate analysis, ESCC patients with hypertension who were treated with CCBs had a better OS than those who were not. Multivariate analysis results indicated that postoperative T stage and N stage are independent risk factors for the OS of ESCC patients with hypertension, while the use of CCBs is an independent protective factor for their OS. Additionally, a nomogram was established to accurately predict the occurrence of adverse outcomes. Conclusion This study finds that long-term CCB use improves OS in hypertensive ESCC patients post-esophagectomy, highlighting the recommendation of CCB therapy in managing hypertensive ESCC patients post-surgery.

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