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Furosemide use and survival in patients with esophageal or gastric cancer: a population-based cohort study

Authors
  • Liu, Peipei1
  • McMenamin, Úna C.1
  • Spence, Andrew D.1, 2
  • Johnston, Brian T.2
  • Coleman, Helen G.1, 3
  • Cardwell, Chris R.1
  • 1 Queen’s University Belfast, Institute for Clinical Science, Royal Victoria Hospital, Centre for Public Health, Grosvenor Road, Belfast, Belfast, Northern Ireland, BT12 6BJ, UK , Belfast (United Kingdom)
  • 2 Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK , Belfast (United Kingdom)
  • 3 Queen’s University Belfast, Centre for Cancer Research and Cell Biology, Belfast, Northern Ireland, UK , Belfast (United Kingdom)
Type
Published Article
Journal
BMC Cancer
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Oct 29, 2019
Volume
19
Issue
1
Identifiers
DOI: 10.1186/s12885-019-6242-8
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundPre-clinical studies have shown that furosemide slows cancer cell growth by acting on the Na-K-2Cl transporter, particularly for gastric cancer cells. However, epidemiological studies have not investigated furosemide use and mortality in gastroesophageal cancer patients. Consequently, we conducted a population-based study to investigate whether furosemide use is associated with reduced cancer-specific mortality in esophageal/gastric cancer patients.MethodsA cohort of patients newly diagnosed with esophageal or gastric cancer between 1998 and 2013 were identified from English cancer registries and linked to the Clinical Practice Research Datalink to provide prescription records and the Office of National Statistics to provide death data up to September 2015. Time-dependant Cox-regression models were used to calculate hazard ratios (HRs) comparing cancer-specific mortality in furosemide users with non-users. Analyses were repeated restricting to patients with common furosemide indications (heart failure, myocardial infarction, edema or hypertension) to reduce potential confounding.ResultsThe cohort contained 2708 esophageal cancer patients and 2377 gastric cancer patients, amongst whom 1844 and 1467 cancer-specific deaths occurred, respectively. Furosemide use was not associated with reduced cancer-specific mortality overall (adjusted HR in esophageal cancer = 1.28, 95% CI 1.10, 1.50 and in gastric cancer = 1.27, 95% CI 1.08, 1.50) or when restricted to patients with furosemide indications before cancer diagnosis (adjusted HR in esophageal cancer = 1.07, 95% CI 0.88, 1.30 and in gastric cancer = 1.18, 95% CI 0.96, 1.46).ConclusionsIn this large population-based cohort study, furosemide was not associated with reduced cancer-specific mortality in patients with esophageal or gastric cancer.

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