Association of aspirin and nonaspirin NSAIDs therapy with the incidence risk of hepatocellular carcinoma: a systematic review and meta-analysis on cohort studies

Abstract

According to the current research evidence, the therapy of nonsteroidal anti-inflammatory drugs (NSAIDs) might effectively decrease the risk of hepatocellular carcinoma (HCC) incidence. Investigations have been conducted on the relationship between NSAIDs (aspirin and nonaspirin NSAIDs) and the risk of HCC incidence. We searched the PubMed, Web of Science, Embase and Cochrane Library databases for cohort studies published prior to 15 March 2020 and screened eligible studies. There were a total of 12 eligible studies (published between 2012 and 2020). We observed a lower risk of HCC among aspirin users [hazard ratio 0.53; 95% confidence interval (CI), 0.43-0.65]. However, there were no statistically significant associations discovered between nonaspirin NSAID use and the risk of HCC incidence (hazard ratio 0.95; 95% CI, 0.79-1.15). Furthermore, aspirin use has also been found to reduce the risk of HCC in patients with cirrhosis or viral hepatitis compared to that in the general population (hazard ratio 0.15; 95% CI, 0.10-0.23; hazard ratio 0.65; 95% CI, 0.56-0.76, respectively). Moreover, no statistical associations were found between aspirin use and a higher risk of bleeding risk, with a hazard ratio value of 0.76 (95% CI, 0.51-1.13). In summary, the conducted meta-analysis reveals that aspirin, rather than nonaspirin NSAIDs, can significantly decrease the risk of HCC, particularly in patients with cirrhosis or viral hepatitis.

Association of perioperative use of statins, metformin, and aspirin with recurrence after curative liver resection in patients with hepatocellular carcinoma: A propensity score matching analysis

“…Another study using the same database showed that aspirin and clopidogrel increase the RFS and OS of patients with HBV‐related HCC after liver resection 39 . However, a meta‐analysis on HCC recurrence after liver resection showed that aspirin alone does not reduce recurrence 52 . The present study adds to these findings by showing no association between aspirin use and survival outcomes after curative liver resection for HCC.…”

“…39 However, a meta-analysis on HCC recurrence after liver resection showed that aspirin alone does not reduce recurrence. 52 The present study adds to these findings by showing no association between aspirin use and survival outcomes after curative liver resection for HCC. This study has some limitations.…”

Beneficial Prognostic Effects of Aspirin in Patients Receiving Sorafenib for Hepatocellular Carcinoma: A Tale of Multiple Confounders

“…In this retrospective study, aspirin use was associated with longer survival in patients with unresectable HCC not amenable to locoregional procedures and treated with sorafenib. Aspirin might prevent the development of HCC in at-risk patients [ 2 , 9 , 10 ], although its impact on the prognosis of patients who already developed HCC remains undefined. In this respect, patients receiving curative procedures have never been investigated, likely due to the fact that these therapies eradicate the target tumor and its recurrence is usually bound to either a de novo HCC or metastatic lesions.…”

Побочные Эффекты Нестероидных Противовоспалительных Средств И Пути Их Профилактики

“…Èíòåðåñíûìè îêàçàëèñü ðåçóëüòàòû íåäàâíåãî àíàëèçà ðèñêà è ÷àñòîòû âûÿâëåíèÿ ãåïàòîöåëëþëÿðíîé êàðöèíîìû [41]. Îêàçàëîñü, ÷òî ÀÑÊ, íî íå äðóãèå ÍÏÂÑ, ìîaeåò çíà÷èòåëüíî ñíèçèòü ðèñê ãåïàòîöåëëþëÿðíîé êàðöèíîìû, îñîáåííî ó ïàöèåíòîâ ñ öèððîçîì ïå÷åíè èëè âèðóñíûì ãåïàòèòîì.…”