Postoperative Impact of Anti-Inflammatory Drug on Cancer Recurrence in Patients With Locally Advanced Gastric Cancer After Curative Gastrectomy: A Pilot Retrospective Study.

[BACKGROUND] Elevated postoperative inflammation is associated with reduced recurrence-free survival (RFS) after gastrectomy in patients with gastric cancer, independent of postoperative complications. The effect of the administration of anti-inflammatory drugs immediately after gastrectomy on prolonging RFS in patients with gastric cancer has not been fully investigated. In this study, we aimed to investigate the effects of anti-inflammatory drugs on the long-term recurrence rates of gastric cancer after radical resection.

[METHODS] This retrospective cohort study included consecutive patients who underwent radical gastrectomy for primary pStage II-III gastric cancer between May 2006 and March 2017. We performed propensity score matching using a logistic regression model to adjust for patient background, compared RFS, and used Cox proportional hazard regression to identify prognostic factors.

[RESULTS] Median duration of follow-up was 62 months. After matching, 591 patients were included in the untreated group, and 197 were included in the group treated with anti-inflammatory drugs. RFS was no significant difference in the two groups (5-year RFS: treated group, 73.2%; untreated group, 68.4%;  = 0.246), but peritoneal recurrence was significantly lower in the treated group ( = 0.028). Multivariate analyses showed that anti-inflammatory drugs were independent prognostic factors for recurrence-free survival (hazard ratio, 0.751; 95% confidence interval, 0.569-0.992;  = 0.044). In the subgroup analysis, using multivariate analysis for recurrence-free survival, anti-inflammatory drugs were more effective in patients with pStage III than in those with pStage II disease.

[CONCLUSION] Anti-inflammatory drug administration after radical resection may prolong recurrence-free survival in patients with pStage III gastric cancer.