Intraoperative use of single dose of nonsteroidal anti-inflammatory drugs was not associated with cancer recurrence and mortality after bladder cancer surgery: a retrospective study

Shiyu Mao, Yuan Wu, Ruiliang Wang, Yadong Guo, Jing Yuan, Wenchao Ma, Wentao Zhang, Junfeng Zhang, Yang Yan, Xudong Yao


Background: Recently, intraoperative use of nonsteroidal anti-inflammatory drugs (NSAIDs) has been demonstrated to be associated with improved outcomes after surgery for several cancers; however, the effect of intraoperative NSAIDs use on bladder cancer (BCa) is not known. Therefore, the present study investigated the association between intraoperative NSAIDs use and oncological outcomes after radical cystectomy (RC).
Methods: We retrospectively analyzed 248 patients with BCa who underwent RC. Kaplan-Meier analysis and a Cox regression model were used to evaluate the association between intraoperative NSAIDs (parecoxib) use and oncological outcomes after RC.
Results: After excluding 63 patients, 82 of the remaining 185 patients received parecoxib during surgery. In the parecoxib group, the overall recurrence rate did not decrease significantly (P=0.310). Time to recurrence, cancer-specific mortality, and overall mortality were not significantly different between the groups. Kaplan- Meier analysis showed no association of the intraoperative use of parecoxib with an improved recurrence-free survival (RFS) or overall survival (OS) (P=0.431, P=0.185, respectively). Similarly, the multivariate analysis model showed no association between the administration of parecoxib and RFS [hazard ratio (HR), 0.964; 95% confidence interval (CI), 0.599–1.551, P=0.878] or OS (HR, 1.043; 95% CI, 0.621–1.750; P=0.875). In these patients, elevated preoperative neutrophil-lymphocyte ratio (NLR) was demonstrated to be associated with RFS and OS.
Conclusions: The present study found that intraoperative parecoxib use was not associated with improved outcome after BCa surgery. Prospective, randomized trials should be performed to further evaluate the results of this study.