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Single dose of dexamethasone is not associated with postoperative recurrence and mortality in breast cancer patients: a propensity-matched cohort study

 Myoung Hwa Kim  ;  Dong Wook Kim  ;  Seho Park  ;  Joo Heung Kim  ;  Ki Young Lee  ;  Jisung Hwang  ;  Young Chul Yoo 
 BMC CANCER, Vol.19(1) : 251, 2019 
Journal Title
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Breast cancer ; Dexamethasone ; Glucocorticoids ; Immunosuppression ; Mortality ; Recurrence
BACKGROUND: Dexamethasone is widely used in cancer patients despite the concern that perioperative glucocorticoids may potentially cause immunosuppression. However, studies on the influence of dexamethasone on cancer recurrence after curative surgery have produced conflicting results. The goal of our study was to compare postoperative recurrence-free survival and overall survival between patients with breast cancer who received perioperative dexamethasone and those who did not. METHODS: The medical records of 2729 patients who underwent breast cancer surgery between November 2005 and December 2010 were reviewed. These patients were followed up until December 2015. The patients were categorised according whether they received a single dose of intravenous dexamethasone perioperatively or not. Cox regression analyses were conducted to evaluate any associations between dexamethasone usage with postoperative recurrence and mortality. Additionally, we performed a sensitivity test with propensity score matching to adjust for selection bias. RESULTS: Among the 2628 patients, 236 (8.5%) received perioperative dexamethasone. No increasing risk for recurrence (hazard ratio [HR], 1.442; 95% confidence interval [CI], 0.969-2.145; P = 0.071) or mortality (HR, 1.256; 95% CI, 0.770-2.047; P = 0.361) after breast cancer surgery were identified in patients who received dexamethasone. Similarly, propensity score matching did not show significant associations in postoperative recurrence (HR, 1.389; 95% CI, 0.904-2.132; P = 0.133) or mortality (HR, 1.506; 95% CI, 0.886-2.561; P = 0.130) in patients who received dexamethasone. CONCLUSIONS: We found that a perioperative single dose of dexamethasone is not associated with increased recurrence or mortality after curative surgery in breast cancer patients.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Yoo, Young Chul(유영철) ORCID logo https://orcid.org/0000-0002-6334-7541
Lee, Ki Young(이기영) ORCID logo https://orcid.org/0000-0003-4893-3195
Hwang, Jisung(황지성)
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