Background

Head and neck cancer (HNC) has low 5-year survival, and evidence-based recommendations for tertiary prevention are lacking. Aspirin improves outcomes for cancers at other sites, but its role in HNC tertiary prevention remains understudied.

Methods

HNC patients were recruited in the University of Michigan Head and Neck Cancer Specialized Program of Research Excellence (SPORE) from 2003 to 2014. Aspirin data were collected through medical record review; outcomes (overall mortality, HNC-specific mortality, and recurrence) were collected through medical record review, Social Security Death Index, or LexisNexis. Cox proportional hazards models were used to evaluate the associations between aspirin use at diagnosis (yes/no) and HNC outcomes.

Results

We observed no statistically significant associations between aspirin and cancer outcome in our HNC patient cohort (n = 1161) (HNC-specific mortality: HR = 0.91, 95% CI = 0.68–1.21; recurrence: HR = 0.94, 95% CI = 0.73–1.19). In analyses stratified by anatomic site, HPV status, and disease stage, we observed no association in any strata examined with the possible exception of a lower risk of recurrence in oropharynx patients (HR = 0.60, 95% CI 0.35–1.04).

Conclusions

Our findings do not support a protective association between aspirin use and cancer-specific death or recurrence in HNC patients, with the possible exception of a lower risk of recurrence in oropharynx patients.

中文翻译：

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阿司匹林的使用与头颈癌的生存和复发

背景

头颈癌 (HNC) 的 5 年生存率较低，且缺乏基于证据的三级预防建议。阿司匹林可以改善其他部位癌症的治疗效果，但其在 HNC 三级预防中的作用仍未得到充分研究。

方法

2003 年至 2014 年，密歇根大学头颈癌专业研究卓越计划 (SPORE) 招募了 HNC 患者。阿司匹林数据通过病历审查收集；通过医疗记录审查、社会保障死亡指数或 LexisNexis 收集结果（总体死亡率、HNC 特异性死亡率和复发）。Cox 比例风险模型用于评估诊断时使用阿司匹林（是/否）与 HNC 结果之间的关联。

结果

我们在 HNC 患者队列中观察到阿司匹林与癌症结果之间没有统计学上的显着关联（n  = 1161）（HNC 特异性死亡率：HR = 0.91，95% CI = 0.68–1.21；复发：HR = 0.94，95% CI = 0.73 –1.19）。在按解剖部位、HPV 状态和疾病分期进行分层的分析中，我们观察到，除了口咽部患者的复发风险较低之外，我们在任何检查的分层中都没有发现关联（HR = 0.60，95% CI 0.35-1.04）。

结论

我们的研究结果不支持阿司匹林使用与 HNC 患者癌症特异性死亡或复发之间存在保护性关联，但口咽患者复发风险较低可能除外。