title: Meta-analysis of the effects of beta blocker on survival time in cancer patients.
abstract: OBJECTIVE
  This study was to elucidate the potential benefit of beta blockers on cancer survival.
  
  
  METHODS
  We comprehensively searched PubMed, Embase, and the Cochrane Library from their inception to April 2013. Two authors independently screened and reviewed the eligibility of each study and coded the participants, treatment, and outcome characteristics. The primary outcomes were overall survival (OS) and disease-free survival (DFS).
  
  
  RESULTS
  Twelve studies published between 1993 and 2013 were included in the final analysis. Four papers reported results from 10 independent groups, resulting in a total of 18 comparisons based on data obtained from 20,898 subjects. Effect sizes (hazard ratios, HR) were heterogeneous, and random-effects models were used in the analyses. The meta-analysis demonstrated that beta blocker use is associated with improved OS (HR 0.79; 95 % CI 0.67-0.93; p = 0.004) and DFS (HR 0.69; 95 % CI 0.53-0.91; p = 0.009). Although statistically not significant, the effect size was greater in patients with low-stage cancer or cancer treated primarily with surgery than in patients with high-stage cancer or cancer treated primarily without surgery (HR 0.60 vs. 0.78, and 0.60 vs. 0.80, respectively). Although only two study codes were analyzed, the studies using nonselective beta blockers showed that there was no overall effect on OS (HR 0.52, 95 % CI 0.09-3.04).
  
  
  CONCLUSIONS
  This meta-analysis provides evidence that beta blocker use can be associated with the prolonged survival of cancer patients, especially patients with early-stage cancer treated primarily with surgery.
authors.affiliation: Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Ku, Seoul, 135-710, Korea.
authors.forename: Chel Hun
authors.initials: CH
authors.lastname: Choi
authors.forename: Taejong
authors.initials: T
authors.lastname: Song
authors.forename: Tae Hyun
authors.initials: TH
authors.lastname: Kim
authors.forename: Jun Kuk
authors.initials: JK
authors.lastname: Choi
authors.forename: Jin-Young
authors.initials: JY
authors.lastname: Park
authors.forename: Aera
authors.initials: A
authors.lastname: Yoon
authors.forename: Yoo-Young
authors.initials: YY
authors.lastname: Lee
authors.forename: Tae-Joong
authors.initials: TJ
authors.lastname: Kim
authors.forename: Duk-Soo
authors.initials: DS
authors.lastname: Bae
authors.forename: Jeong-Won
authors.initials: JW
authors.lastname: Lee
authors.forename: Byoung-Gie
authors.initials: BG
authors.lastname: Kim
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy* / Q000401:mortality* / Q000601:surgery; D016019:Survival Analysis
chemical_list: D000319:Adrenergic beta-Antagonists