ArticleBMJ open2020
Effects of beta-blocker therapy on mortality after elective colon cancer surgery: a Swedish nationwide cohort study.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- Beta-blocker use and survival outcomes in colorectal cancer patients: A systematic review and meta-analysis.The Journal of international medical research · 2025Pooled it
- Beta-Blocker Use in Patients Undergoing Non-Cardiac Surgery: A Systematic Review and Meta-Analysis.Medical sciences (Basel, Switzerland) · 2024Pooled it
- Cancer and Hypertension: Shared Mechanisms, Treatment Interactions, and Clinical Management.Cancer medicine · 2026Review
- Targeting β-Adrenergic Signaling in Colorectal Cancer: Molecular Mechanisms and Therapeutic Potential of β-Blockers.Cancers · 2026Review
- Neuro-immune interactions in gastrointestinal oncology: Mechanisms, challenges, and therapeutic potential.Innovation (Cambridge (Mass.)) · 2026Review
- Peripheral Nerve-Cancer Interactions in the Tumor Microenvironment: A Three-Dimensional Framework Integrating Mechanisms, Modulators, and Therapeutic Strategies.Research (Washington, D.C.) · 2026Review
- The neuro-immune axis in cancer: from mechanisms to therapeutic opportunities.Journal of hematology & oncology · 2025Review
- Pharmacological interventions targeting β-adrenoceptors in colorectal cancer: an evolving paradigm.Inflammopharmacology · 2025Review
- Pre- and post-diagnostic use of antihypertensive medications and stage I-III colorectal cancer survival: prospective cohort study.Journal of the National Cancer Institute · 2025Article
- Postdiagnostic use of antihypertensive medications and survival in colorectal, lung, corpus uteri, melanoma and kidney cancer patients with hypertension.BMC cancer · 2025Article
- Impact of previous treatment history and B-cell depletion treatment duration on infection risk in relapsing-remitting multiple sclerosis: a nationwide cohort study.Journal of neurology, neurosurgery, and psychiatry · 2024Article
- A nationwide analysis on the interaction between frailty and beta-blocker therapy in hip fracture patients.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023Article
- Nerves in gastrointestinal cancer: from mechanism to modulations.Nature reviews. Gastroenterology & hepatology · 2022Review
- Cancer Metastasis and Treatment Resistance: Mechanistic Insights and Therapeutic Targeting of Cancer Stem Cells and the Tumor Microenvironment.Biomedicines · 2022Review
- Long-term use of antihypertensive medications, hypertension and colorectal cancer risk and mortality: a prospective cohort study.British journal of cancer · 2022Article
- Mitigating the stress response to improve outcomes for older patients undergoing emergency surgery with the addition of beta-adrenergic blockade.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Review
- Pharmacological differences between beta-blockers and postoperative mortality following colon cancer surgery.Scientific reports · 2022Article
- Beta-Blocker Therapy Is Associated With Increased 1-Year Survival After Hip Fracture Surgery: A Retrospective Cohort Study.Anesthesia and analgesia · 2021Observational
- Article
- Statin therapy and postoperative short-term mortality after rectal cancer surgery.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2021Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveColon cancer surgery remains associated with substantial postoperative morbidity and mortality despite advances in surgical techniques and care. The trauma of surgery triggers adrenergic hyperactivation which drives adverse stress responses. We hypothesised that outcome benefits are gained by reducing the effects of hyperadrenergic activity with beta-blocker therapy in patients undergoing colon cancer surgery. This study aims to test this hypothesis.
designRetrospective cohort study. SETTING AND
participantsThis is a nationwide study which includes all adult patients undergoing elective colon cancer surgery in Sweden over 10 years. Patient data were collected from the Swedish Colorectal Cancer Registry. The national drugs registry was used to obtain information about beta-blocker use. Patients were subdivided into exposed and unexposed groups. The association between beta-blockade, short-term and long-term mortality was evaluated using Poisson regression, Kaplan-Meier curves and Cox regression. PRIMARY AND SECONDARY OUTCOMES: Primary outcome of interest was 1-year all-cause mortality. Secondary outcomes included 90-day all-cause and 5-year cancer-specific mortality.
resultsThe study included 22 337 patients of whom 36.1% were prescribed preoperative beta-blockers. Survival was higher in patients on beta-blockers up to 1 year after surgery despite this group being significantly older and of higher comorbidity. Regression analysis demonstrated significant reductions in 90-day deaths (IRR 0.29, 95% CI 0.24 to 0.35, p<0.001) and a 43% risk reduction in 1-year all-cause mortality (adjusted HR 0.57, 95% CI 0.52 to 0.63, p<0.001) in beta-blocked patients. In addition, cancer-specific mortality up to 5 years after surgery was reduced in beta-blocked patients (adjusted HR 0.80, 95% CI 0.73 to 0.88, p<0.001).
conclusionPreoperative beta-blockade is associated with significant reductions in postoperative short-term and long-term mortality following elective colon cancer surgery. Its potential prophylactic effect warrants further interventional studies to determine whether beta-blockade can be used as a way of improving outcomes for this patient group.
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Registered trials
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