Impact of angiotensin system inhibitors on esophageal Cancer survival

Abstract Introduction Angiotensin system inhibitors (ASIs) is associated with improved prognosis in patients with gastrointestinal and hepatobiliary cancers. Data suggest that renin-angiotensin system signaling stimulates the tumor's immune microenvironment to impact overall survival (OS). This goal of this study is to investigate the role of ASI use on the OS and disease free survival (DFS) of esophageal cancer patients. Methods Retrospective review of esophagectomy patients with esophageal adenocarcinoma and squamous cell cancer at a single institution tertiary care center from 2007 to 2018 was performed. Outcomes include OS and DFS. Patient characteristics were compared with t-test and chi-square test. Survival was analyzed with Kaplan–Meier, and Cox Hazard-Proportional regression. Results 171 patients were identified and 123 underwent esophagectomy for cancer. No significant differences in patient demographics were found between ASI users and non-ASI users except for the rates of hypertension (40% vs. 94%, p  Conclusion ASIs have been shown to improve survival and decrease relative risk for several types of cancers; however, our data do not support the same effect on esophageal cancer patients undergoing curative intent surgery. Further research is needed to investigate potential nuances in ASI dose, chronicity of use, esophageal pathology, and applicability to non-surgical candidates.