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Review
. 2014 Jul;140(7):1179-88.
doi: 10.1007/s00432-014-1658-7. Epub 2014 Mar 27.

Meta-analysis of the effects of beta blocker on survival time in cancer patients

Chel Hun Choi  1 , Taejong Song, Tae Hyun Kim, Jun Kuk Choi, Jin-Young Park, Aera Yoon, Yoo-Young Lee, Tae-Joong Kim, Duk-Soo Bae, Jeong-Won Lee, Byoung-Gie Kim
Affiliations
Review

Meta-analysis of the effects of beta blocker on survival time in cancer patients

Chel Hun Choi et al. J Cancer Res Clin Oncol. 2014 Jul.

Abstract

Purpose: This study was to elucidate the potential benefit of beta blockers on cancer survival.

Methods: We comprehensively searched PubMed, Embase, and the Cochrane Library from their inception to April 2013. Two authors independently screened and reviewed the eligibility of each study and coded the participants, treatment, and outcome characteristics. The primary outcomes were overall survival (OS) and disease-free survival (DFS).

Results: Twelve studies published between 1993 and 2013 were included in the final analysis. Four papers reported results from 10 independent groups, resulting in a total of 18 comparisons based on data obtained from 20,898 subjects. Effect sizes (hazard ratios, HR) were heterogeneous, and random-effects models were used in the analyses. The meta-analysis demonstrated that beta blocker use is associated with improved OS (HR 0.79; 95 % CI 0.67-0.93; p = 0.004) and DFS (HR 0.69; 95 % CI 0.53-0.91; p = 0.009). Although statistically not significant, the effect size was greater in patients with low-stage cancer or cancer treated primarily with surgery than in patients with high-stage cancer or cancer treated primarily without surgery (HR 0.60 vs. 0.78, and 0.60 vs. 0.80, respectively). Although only two study codes were analyzed, the studies using nonselective beta blockers showed that there was no overall effect on OS (HR 0.52, 95 % CI 0.09-3.04).

Conclusion: This meta-analysis provides evidence that beta blocker use can be associated with the prolonged survival of cancer patients, especially patients with early-stage cancer treated primarily with surgery.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Study flow diagram
Fig. 2
Fig. 2
Funnel plot of comparison: beta blocker versus control group for all studies. Outcome: OS for all patients. There may be some factors accounting for the small amount of asymmetry, such as the exclusion of small trials with negative results that were not published, differences in trial quality or true study heterogeneity
Fig. 3
Fig. 3
Meta-analysis of OS: beta blocker versus control
Fig. 4
Fig. 4
Meta-analysis of OS according to stage
Fig. 5
Fig. 5
Meta-analysis of OS according to primary treatment (with or without surgery)
Fig. 6
Fig. 6
Meta-analysis of DFS: beta blocker versus control
See this image and copyright information in PMC

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