Open AccessAssociation of perioperative blood pressure with long‐term survival in rectal cancer patients
Author(s) -
Yu HuiChuan,
Luo YanXin,
Peng Hui,
Wang XiaoLin,
Yang ZiHuan,
Huang MeiJin,
Kang Liang,
Wang Lei,
Wang JianPing
Publication year - 2016
Publication title -
cancer communications
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.119
H-Index - 53
ISSN - 2523-3548
DOI - 10.1186/s40880-016-0100-8
Subject(s) - medicine , hazard ratio , perioperative , blood pressure , colorectal cancer , confidence interval , univariate analysis , proportional hazards model , cancer , surgery , gastroenterology , multivariate analysis
Background Several studies suggested that hypertension is positively related to cancer incidence and mortality. In this study, we investigated the association between perioperative blood pressure (BP) and long‐term survival outcomes in patients with rectal cancer. Methods This study included a cohort of 358 patients with stages I–III rectal cancer who underwent a curative resection between June 2007 and June 2011. Both pre‐ and postoperative BPs were measured, by which patients were grouped (low BP: <120/80 mmHg; high BP: ≥120/80 mmHg). The survival outcomes were compared between these two groups. The primary endpoints were disease‐free survival (DFS) and cancer‐specific survival (CSS). Results Univariate analysis showed that patients with high preoperative systolic BP had lower 3‐year DFS (67.2% vs. 82.1%, P = 0.041) and CSS rates (81.9% vs. 94.8%, P = 0.003) than patients with low preoperative systolic BP, and the associations remained significant in the Cox multivariate analysis, with the adjusted hazard ratios equal to 1.97 [95% confidence interval (CI) = 1.08–3.60, P = 0.028] and 2.85 (95% CI = 1.00–8.25, P = 0.050), respectively. Similarly, in postoperative evaluation, patients with high systolic BP had significantly lower 3‐year CSS rates than those with low systolic BP (78.3% vs. 88.9%, P = 0.032) in univariate analysis. Moreover, high pre‐ and/or postoperative systolic BP presented as risk factors for CSS in the subgroups of patients who did not have a history of hypertension, with and/or without perioperative administration of antihypertensive drugs. Conclusions High preoperative systolic BP was an independent risk factor for both CSS and DFS rates, and high postoperative systolic BP was significantly associated with a low CSS rate in rectal cancer patients. Additionally, our results suggest that rectal cancer patients may get survival benefit from BP control in perioperative care. However, further studies should be conducted to determine the association between BP and CSS and targets of BP control.