The effects of beta-blocker use on cancer prognosis: a meta-analysis based on 319,006 patients
Received 6 March 2018
Accepted for publication 31 May 2018
Published 20 August 2018 Volume 2018:11 Pages 4913—4944
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 3
Editor who approved publication: Dr Yao Dai
Zhijing Na,1,* Xinbo Qiao,1,* Xuanyu Hao,2 Ling Fan,3 Yao Xiao,4 Yining Shao,4 Mingwei Sun,4 Ziyi Feng,4 Wen Guo,4 Jiapo Li,1 Jiatong Li,5 Dongyang Li6
1Department of Post-graduate, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, People’s Republic of China; 2Department of Rheumatology and Immunology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110022, People’s Republic of China; 3Department of Nursing, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, People’s Republic of China; 4The First Clinical Department of China Medical University, Shenyang, Liaoning 110122, People’s Republic of China; 5Department of Undergraduate, The First Clinical Academy of China Medical University, Shenyang, Liaoning 110001, People’s Republic of China; 6Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, People’s Republic of China
*These authors contributed equally to this work
Background: Beta-blockers are antihypertensive drugs and have shown potential in cancer prognosis. However, this benefit has not been well defined due to inconsistent results from the published studies.
Methods: To investigate the association between administration of beta-blocker and cancer prognosis, we performed a meta-analysis. A literature search of PubMed, Embase, Cochrane Library, and Web of Science was conducted to identify all relevant studies published up to September 1, 2017. Thirty-six studies involving 319,006 patients were included. Hazard ratios were pooled using a random-effects model. Subgroup analyses were conducted by stratifying ethnicity, duration of drug use, cancer stage, sample size, beta-blocker type, chronological order of drug use, and different types of cancers.
Results: Overall, there was no evidence to suggest an association between beta-blocker use and overall survival (HR=0.94, 95% CI: 0.87–1.03), all-cause mortality (HR=0.99, 95% CI: 0.94–1.05), disease-free survival (HR=0.59, 95% CI: 0.30–1.17), progression-free survival (HR=0.90, 95% CI: 0.79–1.02), and recurrence-free survival (HR=0.99, 95% CI: 0.76–1.28), as well. In contrast, beta-blocker use was significantly associated with better cancer-specific survival (CSS) (HR=0.78, 95% CI: 0.65–0.95). Subgroup analysis generally supported main results. But there is still heterogeneity among cancer types that beta-blocker use is associated with improved survival among patients with ovarian cancer, pancreatic cancer, and melanoma.
Conclusion: The present meta-analysis generally demonstrates no association between beta-blocker use and cancer prognosis except for CSS in all population groups examined. High-quality studies should be conducted to confirm this conclusion in future.
Keywords: cancer, prognosis, beta-blocker, meta-analysis
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