Role of anti-stromal polypharmacy in increasing survival after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma

Table 1 Differences in Kaplan-Meier estimated median survival between individual drugs groups

Drug name	Number taking the drug out of 164 patients	Median survival estimate for those taking the drug (d)	Median survival for those not taking the drug (d)	P value (log rank test)
ACEI/ARB	41	539	611	0.652
CCB	26	815	528	0.061
Aspirin	55	504	546	0.846
Statins	39	504	577	0.368

Significance calculated using log-rank tests. ACEI/ARB: Angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers; CCB: Calcium channel blockers.

Table 2 Univariate and multivariate cox regression comparing individual drug groups with those not taking the drug

Drug name	Number taking the drug out of 164 patients	Univariate analysis		Multivariate analysis
		HR (95%CI)	P-value	HR (95%CI)	P-value
ACEI/ARB	41	1.094 (0.741-1.614)	0.653	1.129 (0.617-2.065)	0.693
CCB	26	0.635 (0.393-1.025)	0.063	0.475 (0.250-0.902)	0.023
Aspirin	55	1.036 (0.726-1.479)	0.846	1.041 (0.651-1.667)	0.865
Statins	39	1.200 (0.806-1.787)	0.369	1.055 (0.614-1.814)	0.845

ACEI/ARB: Angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers; CCB: Calcium channel blockers.

Table 3 Kaplan-Meier survival estimates and multivariate cox regression comparing patients taking a combination of medications with patients on one or neither drug

Drug combination	Number of people on	Kaplan-Meier estimated median survival			Multivariate cox regression
	combination out of 164	For those on the drug combination	For those not on drug combination	P-value (log rank)	HR (95%CI)	P-value
CCB + aspirin	15	1414	528	0.012	0.300 (0.122-0.735)	0.008
CCB + statin	12	544	539	0.284	0.413 (0.155-1.101)	0.077
CCB + ACEI/ARB	12	485	541	0.450	0.512 (0.194-1.348)	0.175
Aspirin + statin	27	504	546	0.697	0.969 (0.509-1.844)	0.924
Aspirin + ACEI/ARB	22	485	569	0.923	0.948 (0.438-2.054)	0.893
Statin + ACEI/ARB	21	368	577	0.426	1.126 (0.533-2.379)	0.756

ACEI/ARB: Angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers; CCB: Calcium channel blockers.

Table 4 Comparison of differences in prognostic indicators between drug groups

Characteristics	No CCB/aspirin, n (%)	CCB and aspirin, n (%)	Aspirin without CCB, n (%)	CCB without Aspirin, n (%)	P value
	n = 98	n = 15	n = 40	n = 11
Sex
Male	56 (57.1)	5 (33.3)	25 (62.5)	8 (72.7)	0.169
Age (yr)
< 60	39 (39.8)	5 (33.3)	8 (20.0)	3 (27.3)	0.157
≥ 60	59 (60.2)	10 (66.7)	32 (80.0)	8 (72.7)
Blood pressure status
Hypertensive	27 (27.6)	13 (86.7)	22 (55.0)	11 (100.0)	0.000
Non-hypertensive	71 (72.4)	2 (13.3)	18 (45.0)	0 (0.0)
BMI
< 18.5	2 (2.0)	0 (0)	1 (2.5)	0 (0.0)	0.307
18.5-25	52 (53.1)	5 (33.3)	24 (60.0)	3 (27.3)
> 25	41 (41.8)	9 (60.0)	14 (35.0)	8 (72.7)
Adjuvant chemotherapy
Received post-op	69 (70.4)	9 (60.0)	23 (57.5)	9 (81.8)	0.333
Not received	24 (24.5)	5 (33.3)	13 (32.5)	1 (9.1)
CA19-9
< 47	27 (27.6)	3 (20.0)	9 (22.5)	1 (9.1)	0.437
47-1000	51 (52.0)	7 (46.7)	20 (50.0)	7 (63.6)
> 1000	8 (8.2)	3 (20.0)	6 (15.0)	3 (27.3)
ASA grade
1-2	81 (82.7)	12 (80.0)	22 (55.0)	8 (72.7)	0.008
3-4	17 (17.3)	3 (20.0)	18 (45.0)	3 (27.3)
Resection value
R0	14 (14.3)	6 (40.0)	9 (22.5)	5 (45.5)	0.020
R1	83 (84.7)	9 (60.0)	31 (77.5)	6 (54.5)
T status
T1-2	3 (3.1)	2 (13.3)	1 (2.5)	0 (0.0)	0.199
T3-4	95 (96.9)	13 (86.7)	39 (97.5)	11 (100.0)
N status
N0	7 (7.1)	3 (20.0)	5 (12.5)	0 (0.0)	0.242
N1	90 (91.8)	12 (80)	35 (87.5)	11 (100.0)

P-values were calculated using tests χ² tests. CCB: Calcium channel blockers; ASA: American society of anaesthesiologists; BMI: Body mass index.

Table 5 Kaplan-Meier survival estimates and multivariate cox regression comparing patients taking a combination of calcium channel blockers + aspirin with patients on one or neither drug

Drug group	Number of people	Estimated median	P-value (log rank)	Multivariate cox regression
	in group	survival (d)	compared to control	HR (95%CI)	P-value
Control (no CCB/aspirin)	98	601	-	1	-
CCB + aspirin	15	1414	0.029	0.332 (0.126-0.870)	0.025
Aspirin without CCB	40	392	0.032	1.658 (0.968-2.840)	0.066
CCB without Aspirin	11	343	0.563	1.039 (0.416-2.595)	0.935

CCB: Calcium channel blockers.