Can Aspirin Use Be Associated With the Risk or Prognosis of Bladder Cancer? A Case-Control Study and Meta-analytic Assessment

Abstract

Aspirin, widely used to prevent cardiovascular disease, had been linked to the incidence of bladder cancer (BCa). Existing studies focusing on Chinese populations are relatively rare, especially for Northeast China. Meanwhile, relevant studies on the effects of aspirin on the occurrence or prognosis of BCa are inconsistent or even controversial. First, in the case control study, logistic regression analysis was used to investigate the association between aspirin intake and risk of BCa including 1121 patients with BCa and the 2242 controls. Subsequently, Kaplan-Meier curve and Cox regression analyses were applied to explore the association between aspirin intake and clinicopathological factors which may predict overall survival (OS) and recurrence-free survival (RFS) of BCa patients. Finally, we quantificationally combined the results with those from the published literature evaluating aspirin intake and its effects on the occurrence, outcome of surgery and prognosis of BCa by meta-analysis up to May 1, 2021.Our case-control study demonstrated that the regular use of aspirin was not associated with a reduced incidence of BCa (P=0.175). Stratified analyses of sex showed that aspirin intake did not lead to a lower risk of BCa in female patients (P=0.063). However, the male population who regularly took aspirin had a lower incidence of BCa (OR=0.748, 95% CI= 0.584-0.958, P=0.021). Subgroup analyses stratified by smoking found a significant reduction in the risk of BCa in current smokers with aspirin intake (OR=0.522, 95% CI=0.342-0.797, P=0.002). In terms of prognosis of BCa, patients with a history of aspirin intake did not had a markedly longer OS or RFS than those with no history of aspirin intake by Kaplan-Meier curves. Stratified analysis by sex showed no correlation between aspirin intake and the recurrence or survival of BCa for either male or female patients. However, in people younger than 68, aspirin intake seemed to have prolonged effects for overall survival (HR=3.876; 95% CI=1.326-11.325, P=0.019). Then, we performed a meta-analysis and the combined results from 19 articles and our study involving more than 39524 BCa cases indicated that aspirin intake was not associated with the occurrence of BCa (P=0.671). Subgroup analysis by whether regular use of aspirin, by the mean duration of use of aspirin, by sex, by smoking exposure, by research region and by study type also supported the above results. In terms of the impact of aspirin intake on the prognosis of patients with BCa, 11 articles and our study involving 8825 BCa cases were eligible. The combined results showed that patients with aspirin intake did not have significantly influence on survival, recurrence, progression and metastasis than those without aspirin intake. On the whole, both our retrospective study and literature meta-analysis suggested a lack of a strong relevant association between the use of aspirin and the incidence or prognosis of BCa. Thus, additional long-term follow-up prospective research is warranted to clarify the association of aspirin with BCa incidence and prognosis.

TP53 Mutation for Prediction of Tumor Recurrence and Metastasis in Bladder Cancer Patients

“…The above ndings matched those ofLiao et al, 2021 who that high stage of BC has obviously higher level of TP53 mutation than the lower stage and also consistent with those ofShao et al, 2021 who reported that TP53 mutations were most frequent among BC patients with high tumor grade. The overall analysis provides a strong support to the initial ndings, which further con rmed the potential diagnosis role of TP53 mutation in advanced BC.The occurrence or recurrence of BC is a molecular biological change or process that is effected by occupational factors, non-occupational factors, genomics and proteomics factors(Fan, et al, 2021).The value of TP53 in bladder cancer as a predictive marker of tumor recurrence and treatment selection is still in debate(Sobhani et al, 2021). But the results of our study settled this matter and statistically proved the the clinical value of TP53 in bladder cancer as a predictive marker of both tumor metastasis and recurrence.Analysis of the data using Log Rank Mantel-Cox for tumor recurrence showed a signi cant association between mutation frequency in exons (2 + 3), 4 and tumor recurrence with P = 0.001, 0.008 respectively while no signi cant association was observed in exon 5.…”

Bladder Cancer and Risk Factors: Data from a Multi-Institutional Long-Term Analysis on Cardiovascular Disease and Cancer Incidence

“…CVD treatment and control generally involve a multitude of drugs and related drug-interactions, with a possible effect on cancer incidence. Considering BCa risk, several studies have considered the relationship with aspirin but have demonstrated inconsistent results and overall null associations [ 26 , 27 , 28 ]. Similar results were assessed for any antihypertensive agents or statin use in a population-based case-control study, highlighting the need for additional long-term follow-up prospective research [ 18 , 29 , 30 ].…”