Correlation of supportive proton pump inhibitor use during surgery with outcomes in patients with stage I-III colorectal cancer: A propensity score matching study.

[BACKGROUND] Proton pump inhibitors (PPIs) are widely used to treat cancer patients in different settings and have been found affect patient outcomes. However, the effect of PPI use during the radical resection of colorectal cancer (CRC) has never been addressed.

[PATIENTS AND METHODS] Data about the use of PPIs, including the cumulative dosage (CD) and dosage per day (DpD), were collected retrospectively. Patients were divided into different subgroups before and after propensity score matching (PSM). The differences in disease-free survival (DFS) and overall survival (OS) between these subgroups were assessed after PSM. Finally, risk factors for survival were validated with a Cox proportional hazard model.

[RESULTS] Both CD and DpD significantly predicted DFS but not OS. Significant difference in DFS was found between the low- or high-CD subgroups (log rank = 5.78, P = 0.016); whereas similar difference in OS was only found between the low- or high-DpD subgroups (log rank = 4.15, P = 0.042). Finally, only the DpD was identified as an independent risk factor for both DFS (HR = 1.74, 95 % CI: 1.04-2.91, P = 0.036) and OS (HR = 2.07, 95 % CI: 1.11-3.86, P = 0.023).

[CONCLUSIONS] The use of PPIs during the radical resection of CRC may be correlated with patient outcomes and patients who receive a relatively high DpD tend to have poor outcomes. However, it should be highlighted that the causal relationship between the use of PPIs and survival in these patients is exploratory rather than clinically, which needs to be further validated in future perspective studies.