Beta adrenergic blockade and clinical outcomes in patients with colorectal cancer: A systematic review and meta-analysis

Preclinical and in vitro studies have shown that beta blockade affect colorectal cancer growth and metastasis through the sympathetic nervous system. There is no consensus on the effect of beta blockade on clinical outcomes in patients with colorectal cancer. We conducted a systematic review and meta-analysis to assess the impact of beta blockade on clinical outcomes in patients with colorectal cancer.A systematic review and meta-analysis was conducted through a comprehensive search of the PubMed, EMBASE and the Cochrane Central Library databases for all studies to compare clinical outcomes in colorectal cancer patients based on the use of beta blockade. Pooled data of survival was analyzed.Fourteen studies involving 85993 patients were included in our meta-analysis. The use of beta blockade was associated with improvements in cancer-specific mortality (N = 59621; HR 0.87; 95%CI, 0.76-0.99; P = 0.04)and overall 1-year mortality (N = 37442; HR 0.54; 95%CI, 0.43-0.67; P < 0.00001),while there was no significant difference in overall survival (N = 37975; HR 0.95; 95%CI, 0.85-1.05; P = 0.28). In patients with stage IV colorectal cancer,the use of beta blockade was significantly associated with improvement in progression-free survival (N = 749; HR 0.76; 95%CI, 0.62-0.92; P = 0.005).In this meta-analysis, beta blockade use was associated with a reduction in cancer-specific mortality. The correlation was particularly significant for PFS improvement in patients with stage IV colorectal cancer. beta blockade may be an option for patients with advanced colorectal cancer.