Abstract
Angiotensin II receptor blockers (ARBs) improve the survival rates of patients with various cancers. However, it remains unclear whether ARBs confer a survival benefit on patients with oral squamous cell carcinoma (OSCC). Here, we assessed the associations between ARB use and survival in patients with OSCC of different stages. This was a 10-year retrospective cohort study of OSCC patients. We enrolled 7,558 patients diagnosed with oral cancer between January 2007 and December 2017 whose details had been entered into the Chang Gung Research Database. Seven hundred and fourteen patients were recruited from the Chang Gung Research Database after performing 1:1 propensity score-matching between ARB users and non-users. Cox's regression models with adjusted covariates were employed to detect factors influencing the survival rates of patients with OSCC. Kaplan-Meier analysis revealed that the overall survival (OS) rate of 180-day ARB users increased (p = 0.038). Cox's regression models indicated that ARB use, younger patients, early-stage OSCC, and patients without diabetes mellitus were independently prognostic of improved OS. Increased OS was more prominent in 180-day ARB users in stage III, Iva, and IVb categories. ARB use for more than 180 days is associated with an increased survival rate and is a positive, independent prognostic factor in patients with OSCC. A further two-arm study should be conducted to confirm the clinical usefulness of ARBs in OSCC patients.
Highlights
Oral cancer is one of the most frequently occurring cancers worldwide
Kaplan-Meier analysis revealed that the overall survival (OS) rate of 180-day angiotensin II type receptor blockers (ARBs) users increased (p = 0.038)
ARB use for more than 180 days is associated with an increased survival rate and is a positive, independent prognostic factor in patients with Oral squamous cell carcinoma (OSCC)
Summary
Oral squamous cell carcinoma (OSCC) represents the most common type of oral cancer, constituting approximately 90% of all oral cancers [1]. In 2018, more than 355,000 individuals were diagnosed with oral cancer worldwide, and approximately 177,000 oral cancer-related deaths were reported [2]. The RAS has been implicated in most human cancers; the use of ACEIs/ARBs has been proposed as a promising anti-tumor strategy, which could potentially suppress tumor progression through inhibition of cancer cell proliferation and neovascularization [4]. The combination of ACEIs/ARBs with conventional anti-cancer therapies has been shown to improve clinical outcomes of patients with various types of cancer, including breast, urothelial, and gastrointestinal tract cancers [5,6,7,8]
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