gms | German Medical Science

Introduction: Targeting metastasis and recurrent disease is a major objective in patients with potentially curable NSCLC. COX-2 overexpression is found in lung adeno- and squamous cell carcinoma, and data suggest a reduction of metastasis rate by COX-inhibition. The aim of our study was to assess the effect of long-term intake of the COX-inhibitor acetylsalicylic acid (ASA) on tumor-associated mortality in patients who underwent surgery for NSCLC.

Methods: We conducted a single center retrospective cohort study including patients who were operated on for NSCLC stages I, II and IIIa in the time period from 2002 to 2009. Data recorded were ASA intake at the time of surgery, tumor histology and stage, age, sex, and co-morbidities. Data on mortality and cause of death up to 2012 were obtained from Statistics Austria. Tumor-related survival in the ASA and non-ASA group was compared by Kaplan-Meier analysis and log-rank test.

Results: A total of 1220 patients was included, of which 179 (14.7%) had documented ASA intake. 466 (38.2%) tumor-related and 150 deaths due to other reasons occurred. 676 patients had adeno- and 373 squamous cell carcinoma. Independent of histology, 778 patients had a documented N0, 203 a N1, and 187 a N2 situation. Tumor-related mortality was significantly higher in the ASA group (44.1%, mean survival 2249±130 days) compared to the non-ASA group (37.2%, mean survival 2633±51 days; p=0.012). Tumor-associated mortality was higher in the ASA group in patients with N0 (p=0.006) but showed no difference between the ASA- and non-ASA-group for adenocarcinoma (p=0.064), squamous cell carcinoma (p=0.949), N1 (p=0.18) and N2 (p=0.55) situation.

Conclusion: In our patient cohort, ASA intake did not seem to improve tumor-related survival, independent of histology or lymph node staging.