Do Perioperative NSAIDs Improve Long-term Outcomes after Cancer Surgery?

Pavankumar Kamat


November 24, 2021


  • The use of perioperative non-steroidal anti-inflammatory drugs (NSAIDs) may be associated with increased disease-free survival (DFS) and overall survival (OS) following cancer surgery.

  • This may be dependent on the type of cancer and NSAIDs.

Why this matters

  • Surgical stress may raise the likelihood of cancer recurrence or metastasis following cancer surgery.

  • Anaesthetic interventions may help prevent this process and improve oncological outcomes.

Study design

  • UK researchers conducted a meta-analysis of 16 studies identified through a literature search across electronic databases.

  • Primary outcome: DFS; secondary outcome: OS.

  • Funding: None disclosed.

Key results

  • Perioperative NSAID use was associated with (HR; 95% CI):

    • longer DFS (0.84; 0.73-0.97; P=.02; I2, 60%); and

    • longer OS (0.78; 0.64-0.94; P=.010).

  • No difference was seen between different types of NSAIDs for DFS.

  • Ketorolac use was associated with a significant improvement in OS (HR, 0.63; 95% CI, 0.42-0.95; P=.03).

  • Analysis on the timing of NSAIDs administration demonstrated no significant association between NSAID use and DFS and OS.

  • The cancer-type analysis found an association between NSAID use and survival outcomes in breast and ovarian cancers.


  • Heterogeneity among studies.

  • Risk of selection bias.


Shaji S, Smith C, Forget P. Perioperative NSAIDs and Long-Term Outcomes After cancer Surgery: a Systematic Review and Meta-analysis. Curr Oncol Rep. 2021;23(12):146. doi: 10.1007/s11912-021-01133-8. PMID: 34748112 

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.


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