Abstract
Beta-blockers have been reported to improve prognosis for various cancers, but the usefulness of perioperative administration remains unclear. To assess the efficacy of perioperative administration of landiolol hydrochloride, an intravenous beta-blocker, for lung cancer, we conducted a single-center, retrospective study. This study included patients who participated in a research conducted by Nippon Medical School Hospital from August 2012 to November 2013. The main selection criteria were males and females younger than 85 years old who have undergone anatomic lung resection for lung malignancies. Fifty-seven patients, 28 in the landiolol group and 29 in the control group, were included. The postoperative relapse-free survival rate at 2 years was 0.89 (95% CI, 0.78–1.01) in the landiolol group and 0.76 (95% CI, 0.60–0.91) in the control group (Chi-squared test; P = 0.1828). The relapse-free survival rate tended to be higher in the landiolol group than in the control. Hazard ratio for relapse-free survival in the landiolol group compared to the control was 0.41 (95% CI, 0.13–1.34), demonstrating that relapse free survival was prolonged in the landiolol group (log-rank test; P = 0.1294). It was suggested that relapse-free survival was prolonged when landiolol hydrochloride was administered from the induction to completion of anesthesia. Further studies are needed to confirm our findings.
Highlights
Surgery is considered the main treatment for lung cancer in patients with clinical stage IIIA or less severe stages, whereas radiotherapy or chemotherapy is attempted for those with stage IIIB or more severe stages[3]
According to study reports of oral beta-blockers and human atrial natriuretic peptide (hANP), we considered that administration of landiolol hydrochloride during lung cancer surgery might suppress relapses and metastases
We previously reported that administration of landiolol hydrochloride in lung cancer patients during the perioperative period significantly suppressed atrial fibrillation postoperatively[18]
Summary
Surgery is considered the main treatment for lung cancer in patients with clinical stage IIIA or less severe stages, whereas radiotherapy or chemotherapy is attempted for those with stage IIIB or more severe stages[3]. Circulating tumor cells are reportedly dispersed during surgery[4] and are associated with early relapse after lung cancer surgery. Administration of human atrial natriuretic peptide (hANP), a drug for heart failure, for 3 days during the perioperative period inhibited adhesion of the dispersed circulating tumor cells to vascular endothelial cells and suppressed relapses after lung cancer surgery[5]. According to study reports of oral beta-blockers and hANPs, we considered that administration of landiolol hydrochloride during lung cancer surgery might suppress relapses and metastases. We previously reported that administration of landiolol hydrochloride in lung cancer patients during the perioperative period significantly suppressed atrial fibrillation postoperatively[18]. We have conducted a retrospective, exploratory clinical study to evaluate effects of landiolol hydrochloride on relapses and metastases if it is administered during the perioperative period
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