Association between perioperative beta blocker use and cancer survival following surgical resection

Background: Recent studies have demonstrated an association between beta-blocker exposure and improved survival in multiple cancer types. We sought to investigate the effects of beta-blockers at the time of index surgery for breast, lung, and colorectal cancer. Materials and methods: Using linked data from a provincial cancer registry, we conducted a retrospective matched cohort study comparing disease-specific and overall survival between patients over age 64 exposed and not exposed to beta-blockers before and after index surgical resection for breast, lung and colorectal cancer between April 1st, 2002 and December 31st, 2010. A high-dimensional propensity score was used to match patients and Cox proportional hazard models were used to estimate relative risks of the outcomes. Results: 30,020 patients were included in the final matched cohorts. Mean follow up time for breast, lung, and colorectal cancer was 57.6 +/- 30.5, 43.1 +/- 28.7, and 53.4 +/- 31.0 months, respectively. The adjusted hazard ratio for disease-specific mortality for patients exposed to beta-blockers was 1.03 (0.83-1.29) for breast, 1.05 (0.92-1.20) for lung, and 1.10 (0.96-1.25) for the colorectal cancer cohort. Conclusions: In this large population-based study, no association between perioperative beta-blocker exposure and improved cancer-specific survival for breast, lung, or colorectal cancer was demonstrated. (C) 2018 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.