Angiotensin II receptor blockers and oral squamous cell carcinoma survival: A propensity-score-matched cohort study

PLoS One. 2021 Dec 2;16(12):e0260772. doi: 10.1371/journal.pone.0260772. eCollection 2021.

Abstract

Objectives: 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.

Materials and methods: 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.

Results: 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.

Conclusions: 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Angiotensin Receptor Antagonists / therapeutic use*
  • Carcinoma, Squamous Cell / drug therapy*
  • Carcinoma, Squamous Cell / pathology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Mouth Neoplasms / drug therapy*
  • Mouth Neoplasms / pathology
  • Prognosis
  • Propensity Score
  • Retrospective Studies
  • Survival Rate

Substances

  • Angiotensin Receptor Antagonists

Grants and funding

This research was funded by Kaohsiung Chang Gung Memorial Hospital, Taiwan, CFRPG8H0401 and CORPG8J0091 to CNW and SCW. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.