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Research article:
Exposure to sodium channel-inhibiting drugs and cancer survival: protocol for a cohort study using the QResearch primary care database
Reference:
Caroline Fairhurst, Ian Watt, Fabiola Martin, Martin Bland, and William J. Brackenbury(2014) Exposure to sodium channel-inhibiting drugs and cancer survival: protocol for a cohort study using the QResearch primary care database. BMJ Open, doi:
- Link to fulltext article
- Abstract
- Introduction: Metastasis from solid tumours is associated with significant morbidity and mortality, and is the leading cause of cancer-related deaths. Voltage-gated sodium channels (VGSCs) are drug targets for the treatment of epilepsy. VGSCs are also present in cancer cells, where they regulate metastatic cell behaviours, including cellular movement and invasion. Treating cancer cells with the VGSC-inhibiting anticonvulsant phenytoin reduces cellular invasion and migration. Together, these suggest that VGSCs may be useful targets for inhibiting metastasis. The purpose of this study is to test the hypothesis that use of VGSC-inhibiting drugs will reduce metastasis, and therefore increase survival time in cancer patients. Methods and analysis: A cohort study based on primary care data from the QResearch database will include patients with one of three common tumours: breast, bowel, and prostate. The primary outcome will be overall survival from date of cancer diagnosis. Cox proportional hazards regression will be used to compare the survival of cancer patients taking VGSC-inhibiting drugs (including anticonvulsants and Class I antiarrhythmic agents) with cancer patients not exposed to these drugs, adjusting for age and sex. Exposure to VGSC-inhibiting drugs will be defined as having at least one prescription for these drugs prior to cancer diagnosis. High and low exposure groups will be identified based on length of use. A number of sensitivity and secondary analyses will be conducted. Ethics and dissemination: The protocol has been independently peer-reviewed and approved by the QResearch Scientific Board. The project has also been approved by the University of York Ethical Review Process. The results will be presented at international conferences and published in an open access peer-reviewed journal, in accordance with the STROBE criteria.
- Author for correspondence
- William J. Brackenbury
- Email for correspondence
- william.brackenbury@york.ac.uk
Code list: res17: Metastases
117 codes in list
| Code | Coding system | Description | Entity type | List name | |||
|---|---|---|---|---|---|---|---|
| 1D18 | Read | Pain from metastases | symptom | res17: Metastases | |||
| B153 | Read | Secondary malignant neoplasm of liver | symptom | res17: Metastases | |||
| B56 | Read | Secondary and unspecified malignant neoplasm of lymph nodes | symptom | res17: Metastases | |||
| B560 | Read | Secondary and unspec malig neop lymph nodes head/face/neck | symptom | res17: Metastases | |||
| B5600 | Read | Secondary and unspec malig neop of superficial parotid LN | symptom | res17: Metastases | |||
| B5601 | Read | Secondary and unspec malignant neoplasm mastoid lymph nodes | symptom | res17: Metastases | |||
| B5602 | Read | Secondary and unspec malig neop superficial cervical LN | symptom | res17: Metastases | |||
| B5603 | Read | Secondary and unspec malignant neoplasm occipital lymph node | symptom | res17: Metastases | |||
| B5604 | Read | Secondary and unspec malig neop deep parotid lymph nodes | symptom | res17: Metastases | |||
| B5605 | Read | Secondary and unspec malig neop submandibular lymph nodes | symptom | res17: Metastases | |||
| B5606 | Read | Secondary and unspec malig neop of facial lymph nodes | symptom | res17: Metastases | |||
| B5607 | Read | Secondary and unspec malig neop submental lymph nodes | symptom | res17: Metastases | |||
| B5608 | Read | Secondary and unspec malig neop anterior cervical LN | symptom | res17: Metastases | |||
| B5609 | Read | Secondary and unspec malig neop deep cervical LN | symptom | res17: Metastases | |||
| B560-99 | Read | Secondary nodes - head/neck | symptom | res17: Metastases | |||
| B560z | Read | Secondary unspec malig neop lymph nodes head/face/neck NOS | symptom | res17: Metastases | |||
| B561 | Read | Secondary and unspec malig neop intrathoracic lymph nodes | symptom | res17: Metastases | |||
| B56-1 | Read | Lymph node metastases | symptom | res17: Metastases | |||
| B5610 | Read | Secondary and unspec malig neop internal mammary lymph nodes | symptom | res17: Metastases | |||
| B5611 | Read | Secondary and unspec malig neop intercostal lymph nodes | symptom | res17: Metastases | |||
| B5612 | Read | Secondary and unspec malig neop diaphragmatic lymph nodes | symptom | res17: Metastases | |||
| B5613 | Read | Secondary and unspec malig neop ant mediastinal lymph nodes | symptom | res17: Metastases | |||
| B5614 | Read | Secondary and unspec malig neop post mediastinal lymph nodes | symptom | res17: Metastases | |||
| B5615 | Read | Secondary and unspec malig neop paratracheal lymph nodes | symptom | res17: Metastases | |||
| B5616 | Read | Secondary and unspec malig neop superfic tracheobronchial LN | symptom | res17: Metastases | |||
| B5617 | Read | Secondary and unspec malig neop inferior tracheobronchial LN | symptom | res17: Metastases | |||
| B5618 | Read | Secondary and unspec malig neop bronchopulmonary lymph nodes | symptom | res17: Metastases | |||
| B5619 | Read | Secondary and unspec malig neop pulmonary lymph nodes | symptom | res17: Metastases | |||
| B561-99 | Read | Secondary nodes -intrathoracic | symptom | res17: Metastases | |||
| B561z | Read | Secondary and unspec malig neop intrathoracic LN NOS | symptom | res17: Metastases | |||
| B562 | Read | Secondary and unspec malig neop intra-abdominal lymph nodes | symptom | res17: Metastases | |||
| B5620 | Read | Secondary and unspec malig neop coeliac lymph nodes | symptom | res17: Metastases | |||
| B5621 | Read | Secondary and unspec malig neop superficial mesenteric LN | symptom | res17: Metastases | |||
| B5622 | Read | Secondary and unspec malig neop inferior mesenteric LN | symptom | res17: Metastases | |||
| B5623 | Read | Secondary and unspec malig neop common iliac lymph nodes | symptom | res17: Metastases | |||
| B5624 | Read | Secondary and unspec malig neop external iliac lymph nodes | symptom | res17: Metastases | |||
| B562-99 | Read | Secondary nodes - intra.abdom. | symptom | res17: Metastases | |||
| B562z | Read | Secondary and unspec malig neop intra-abdominal LN NOS | symptom | res17: Metastases | |||
| B563 | Read | Secondary and unspec malig neop axilla and upper limb LN | symptom | res17: Metastases | |||
| B5630 | Read | Secondary and unspec malig neop axillary lymph nodes | symptom | res17: Metastases | |||
| B5631 | Read | Secondary and unspec malig neop supratrochlear lymph nodes | symptom | res17: Metastases | |||
| B5632 | Read | Secondary and unspec malig neop infraclavicular lymph nodes | symptom | res17: Metastases | |||
| B5633 | Read | Secondary and unspec malig neop pectoral lymph nodes | symptom | res17: Metastases | |||
| B563-99 | Read | Secondary nodes - axilla/arm | symptom | res17: Metastases | |||
| B563z | Read | Secondary and unspec malig neop axilla and upper limb LN NOS | symptom | res17: Metastases | |||
| B564 | Read | Secondary and unspec malig neop inguinal and lower limb LN | symptom | res17: Metastases | |||
| B5640 | Read | Secondary and unspec malig neop superficial inguinal LN | symptom | res17: Metastases | |||
| B5641 | Read | Secondary and unspec malig neop deep inguinal lymph nodes | symptom | res17: Metastases | |||
| B5642 | Read | Secondary and unspec malig neop popliteal lymph nodes | symptom | res17: Metastases | |||
| B564-99 | Read | Secondary nodes - inguinal/leg | symptom | res17: Metastases | |||
| B564z | Read | Secondary and unspec malig neop of inguinal and leg LN NOS | symptom | res17: Metastases | |||
| B565 | Read | Secondary and unspec malig neop intrapelvic lymph nodes | symptom | res17: Metastases | |||
| B5650 | Read | Secondary and unspec malig neop internal iliac lymph nodes | symptom | res17: Metastases | |||
| B5651 | Read | Secondary and unspec malig neop inferior epigastric LN | symptom | res17: Metastases | |||
| B5652 | Read | Secondary and unspec malig neop circumflex iliac LN | symptom | res17: Metastases | |||
| B5653 | Read | Secondary and unspec malig neop sacral lymph nodes | symptom | res17: Metastases | |||
| B5654 | Read | Secondary and unspec malig neop obturator lymph nodes | symptom | res17: Metastases | |||
| B565-99 | Read | Secondary nodes - intrapelvic | symptom | res17: Metastases | |||
| B565z | Read | Secondary and unspec malig neop intrapelvic LN NOS | symptom | res17: Metastases | |||
| B56y | Read | Secondary and unspec malig neop lymph nodes multiple sites | symptom | res17: Metastases | |||
| B56y-99 | Read | Secondary nodes - multiple | symptom | res17: Metastases | |||
| B56z | Read | Secondary and unspec malig neop lymph nodes NOS | symptom | res17: Metastases | |||
| B56z-99 | Read | Secondary nodes NOS | symptom | res17: Metastases | |||
| B570 | Read | Secondary malignant neoplasm of lung | symptom | res17: Metastases | |||
| B571 | Read | Secondary malignant neoplasm of mediastinum | symptom | res17: Metastases | |||
| B57-1 | Read | Metastases of respiratory and/or digestive systems | symptom | res17: Metastases | |||
| B572 | Read | Secondary malignant neoplasm of pleura | symptom | res17: Metastases | |||
| B573 | Read | Secondary malignant neoplasm of other respiratory organs | symptom | res17: Metastases | |||
| B574 | Read | Secondary malignant neoplasm of small intestine and duodenum | symptom | res17: Metastases | |||
| B5740 | Read | Secondary malignant neoplasm of duodenum | symptom | res17: Metastases | |||
| B5741 | Read | Secondary malignant neoplasm of jejunum | symptom | res17: Metastases | |||
| B5742 | Read | Secondary malignant neoplasm of ileum | symptom | res17: Metastases | |||
| B574z | Read | Secondary malig neop of small intestine or duodenum NOS | symptom | res17: Metastases | |||
| B575 | Read | Secondary malignant neoplasm of large intestine and rectum | symptom | res17: Metastases | |||
| B5750 | Read | Secondary malignant neoplasm of colon | symptom | res17: Metastases | |||
| B5751 | Read | Secondary malignant neoplasm of rectum | symptom | res17: Metastases | |||
| B575z | Read | Secondary malig neop of large intestine or rectum NOS | symptom | res17: Metastases | |||
| B5760 | Read | Secondary malignant neoplasm of retroperitoneum | symptom | res17: Metastases | |||
| B5761 | Read | Secondary malignant neoplasm of peritoneum | symptom | res17: Metastases | |||
| B577 | Read | Secondary malignant neoplasm of liver | symptom | res17: Metastases | |||
| B577-1 | Read | Liver metastases | symptom | res17: Metastases | |||
| B57y | Read | Secondary malignant neoplasm of other digestive organ | symptom | res17: Metastases | |||
| B58 | Read | Secondary malignant neoplasm of other specified sites | symptom | res17: Metastases | |||
| B580 | Read | Secondary malignant neoplasm of kidney | symptom | res17: Metastases | |||
| B5823 | Read | Secondary malignant neoplasm of skin of trunk | symptom | res17: Metastases | |||
| B5826 | Read | Secondary malignant neoplasm of skin of breast | symptom | res17: Metastases | |||
| B583 | Read | Secondary malignant neoplasm of brain and spinal cord | symptom | res17: Metastases | |||
| B5830 | Read | Secondary malignant neoplasm of brain | symptom | res17: Metastases | |||
| B5831 | Read | Secondary malignant neoplasm of spinal cord | symptom | res17: Metastases | |||
| B5832 | Read | Cerebral metastasis | symptom | res17: Metastases | |||
| B583-99 | Read | Secondary Ca brain/spinal cord | symptom | res17: Metastases | |||
| B583z | Read | Secondary malignant neoplasm of brain or spinal cord NOS | symptom | res17: Metastases | |||
| B584 | Read | Secondary malignant neoplasm of other part of nervous system | symptom | res17: Metastases | |||
| B585 | Read | Secondary malignant neoplasm of bone and bone marrow | symptom | res17: Metastases | |||
| B5850 | Read | Pathological fracture due to metastatic bone disease | symptom | res17: Metastases | |||
| B585-99 | Read | Secondary Ca bone/bone marrow | symptom | res17: Metastases | |||
| B586 | Read | Secondary malignant neoplasm of ovary | symptom | res17: Metastases | |||
| B587 | Read | Secondary malignant neoplasm of adrenal gland | symptom | res17: Metastases | |||
| B58y | Read | Secondary malignant neoplasm of other specified sites | symptom | res17: Metastases | |||
| B58y0 | Read | Secondary malignant neoplasm of breast | symptom | res17: Metastases | |||
| B58y5 | Read | Secondary malignant neoplasm of prostate | symptom | res17: Metastases | |||
| B58yz | Read | Secondary malignant neoplasm of other specified site NOS | symptom | res17: Metastases | |||
| B58z | Read | Secondary malignant neoplasm of other specified site NOS | symptom | res17: Metastases | |||
| B58z-99 | Read | Secondary Ca NOS | symptom | res17: Metastases | |||
| B594 | Read | Secondary malignant neoplasm of unknown site | symptom | res17: Metastases | |||
| ByuC | Read | [X]Malignant neoplasm of ill-defined, secondary and unspeci | symptom | res17: Metastases | |||
| ByuC3 | Read | [X]Secondary malignant neoplasm/oth+unspc respiratory organs | symptom | res17: Metastases | |||
| ByuC4 | Read | [X]Secondary malignant neoplasm/oth+unspcfd digestive organs | symptom | res17: Metastases | |||
| ByuC7 | Read | [X]Secondary malignant neoplasm of other specified sites | symptom | res17: Metastases | |||
| EMISNQME41 | Read | Metastasis stage M0 | symptom | res17: Metastases | |||
| EMISNQME42 | Read | Metastasis stage M1 | symptom | res17: Metastases | |||
| EMISNQME43 | Read | Metastasis stage M2 | symptom | res17: Metastases | |||
| EMISNQME44 | Read | Metastasis stage M3 | symptom | res17: Metastases | |||
| EMISNQME45 | Read | Metastasis stage M4 | symptom | res17: Metastases | |||
| EMISNQME46 | Read | Metastasis stage M1a | symptom | res17: Metastases | |||
| EMISNQME47 | Read | Metastasis stage M1b | symptom | res17: Metastases | |||
| EMISNQME48 | Read | Metastasis stage M1c | symptom | res17: Metastases |
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