Abstract
Background
Activities and inhibition of the Renin-Angiotensin-Aldosterone System (RAAS) may affect
the survival of resected pancreatic ductal adenocarcinoma (PDAC) patients
Method
A single-institution retrospective analysis of resected PDAC patients between 2010
and 2019. To estimate the effect of angiotensin system inhibitors (ASIs) on patient
survival, we performed Kaplan Meier analysis, Cox Proportional Hazards model, Propensity
Score Matching (PSM), and inverse probability weighting (IPW) analysis.
Results
742 patients were included in the analysis. The average age was 67.0 years, with a
median follow-up of 24.1 months. The use of ASI was associated with significantly
longer overall survival in univariate (p = 0.004) and multivariable (HR = 0.70 [0.56–0.88],p
= 0.003) adjusted analysis. In a propensity score-matched cohort of 400 patients,
ASI use was again associated with longer overall survival (p = 0.039). Lastly, inverse
probability weighting (IPW) analysis suggested that the use of ASI was associated
with an average treatment effect on the treated (ATT) of HR = 0.68 [0.53–0.86],p =
0.002) for overall survival.
Conclusion
In this single-institution retrospective study focusing on resected PDAC patients,
the use of ASI was associated with longer overall survival in multiple statistical
models. Prospective clinical trials are needed before routine clinical implementation
of ASI as an adjuvant to existing therapy can be recommended.
Keywords
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Article info
Publication history
Published online: December 13, 2022
Accepted:
December 9,
2022
Received:
July 24,
2022
Identification
Copyright
© 2022 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.
