Effects of aspirin and non-steroidal anti-inflammatory drugs on the risk of cholangiocarcinoma: a meta-analysis

Lapumnuaypol, Kamolyut; Tiu, Andrew; Wijarnpreecha, Karn; Ungprasert, Patompong; Mao, Michael A; Cheungpasitporn, Wisit

doi:10.1093/qjmed/hcz039

Cited by 13 publications

(15 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…32 Combination aspirin with other non-steroidal anti-inflammatory drugs (NSAIDs) has been associated with reduced risk of breast cancer, endometrial cancer and cholangiocarcinoma. [33][34][35][36] Furthermore, nutritional screening should be carried out for each HNSCC patient. Peri-operative individualized balanced nutrition plans should be made accordingly.…”

Section: Discussionmentioning

confidence: 99%

<p>Prognosis Value of Platelet Counts, Albumin and Neutrophil-Lymphocyte Ratio of Locoregional Recurrence in Patients with Operable Head and Neck Squamous Cell Carcinoma</p>

Ye¹,

Liao²,

Jiang³

et al. 2020

CMAR

View full text Add to dashboard Cite

Background: Peripheral blood inflammation factor neutrophil-lymphocyte ratio (NLR), platelet count (PLT) and nutritional factor serum albumin (ALB) have been proposed as prognostic markers of head and neck squamous carcinoma cancer (HNSCC) in recent years. In the current study, nomogram predict models based on pre-treatment hematological parameters and a modified risk-stratified score system have been built. Methods: A total of 197 patients with oropharyngeal, hypopharyngeal and laryngeal cancers receiving multimodality treatment between 2012 and 2014 were included. The pre-treatment ALB, neutrophil, lymphocyte and platelet count (PLT) were detected. Cancer-specific survival and locoregional recurrence (LRC) by 5 years' follow-up in the cases were obtained. To integrate clinical characteristics, we propose a modified risk-stratified score system. Kaplan-Meier method, proportional hazards COX model, logistic models were used to establish nomograms within external validation. Results: Five-year LRC was decreased (p=0.004) for 140 patients with pre-treatment NLR <2.77. Five-year LRC and 5-year cancer-specific survival were decreased (p=0.031, p=0.021) with pre-treatment PLT ≥248×10 9 /L. Comparison of univariate parametric models demonstrated that pre-treatment NLR evaluation and PLT>248×10 9 /L were better among tested models. On Bayesian information criteria (BIC) analysis, the optimal prognostic model was then used to develop nomograms predicting 3-and 5-year LRC. The external validation of this predictive model was confirmed in 57 patients from another hospital. Conclusion: Pre-treatment NLR elevation and PLT>248×10 9 /L are promising predictors of prognosis in patients with operable HNSCC. Nomograms based on the pre-treatment hematological markers and modified risk-stratified score system provide distinct risk stratifications. There results provided the feasibility of anti-inflammatory and antiplatelet treatments for HNSCC patients.

show abstract

Section: Discussionmentioning

confidence: 99%

<p>Prognosis Value of Platelet Counts, Albumin and Neutrophil-Lymphocyte Ratio of Locoregional Recurrence in Patients with Operable Head and Neck Squamous Cell Carcinoma</p>

Ye¹,

Liao²,

Jiang³

et al. 2020

CMAR

View full text Add to dashboard Cite

show abstract

“…Hepatolithiasis is also common among patients with CCA, possibly due to biliary stasis that predisposes patients to recurrent bacterial infection and chronic inflammation 1 . Another definitive risk factor is Caroli's syndrome, the cystic dilations of the biliary tree 18 . Exposures to chemical toxins such as thorotrast, dioxins and nitrosamines may also increase the incidence of CCA 1 .…”

Section: Contributing Factorsmentioning

confidence: 99%

“…In the classic model of cholangiocarcinogenesis, chronic biliary inflammation triggered by external stimuli—such as PSC or liver flukes—induces malignant transformation of cholangiocytes 19 . In conjunction with its inherent oxidative stress, chronic biliary inflammation causes ongoing damage to the epithelium—resulting in reactive proliferation, gene mutations, dysplasia and eventually malignant transformation of cholangiocytes 18 . Therefore, altering the course of chronic inflammation would possibly decrease the incidence of CCA and improve survival.…”

Section: Contributing Factorsmentioning

confidence: 99%

“…There have been several case‐control and cohort studies that depicted aspirin use and the risk for BTC, including CCA. Two meta‐analysis of such studies showed that aspirin users had significant reductions in the risk of developing CCA 18,63 . By examining data from 9 observational studies (including 12 535 patients with CCA), Xiong et al 63 reported a 31% decrease in the risk of CCA in aspirin users (odds ratio [OR], 0.69; 95% CI, 0.43‐0.94; I 2 , 97.4%) with more reductions in the risk of iCCA (OR, 0.33; 95% CI, 0.26‐0.39; I 2 , 93.6%) relative to the risk of extrahepatic CCA (OR, 0.56; 95% CI, 0.41‐0.73; I 2 , 0%).…”

Section: Evidence For An Anticancer Effect Of Aspirin On Ccamentioning

confidence: 99%

“…By examining data from 9 observational studies (including 12 535 patients with CCA), Xiong et al 63 reported a 31% decrease in the risk of CCA in aspirin users (odds ratio [OR], 0.69; 95% CI, 0.43‐0.94; I 2 , 97.4%) with more reductions in the risk of iCCA (OR, 0.33; 95% CI, 0.26‐0.39; I 2 , 93.6%) relative to the risk of extrahepatic CCA (OR, 0.56; 95% CI, 0.41‐0.73; I 2 , 0%). The other meta‐analysis was conducted in 2019 to assess the relationship among aspirin, other nonsteroidal antiinflammatory drugs, and risk of BTC—including CCA and cancers of the gallbladder and ampulla of Vater 18 . These investigators combined effect estimates from five high‐quality observational studies (all scoring ≥8 on the Newcastle‐Ottawa quality assessment scale), including one cohort study and four case‐control studies published from 2005 to 2017, and involving a total of 9 200 653 patients from China, the United Kingdom and the United States 18 .…”

Section: Evidence For An Anticancer Effect Of Aspirin On Ccamentioning

confidence: 99%

See 2 more Smart Citations

A potential role for aspirin in the prevention and treatment of cholangiocarcinoma

Shen

2020

Intl Journal of Cancer

View full text Add to dashboard Cite

Cholangiocarcinoma is the second most common primary hepatic cancer, with a rising incidence worldwide. Owing to late diagnosis and limited treatment options, the prognosis for cholangiocarcinoma remains dismal, compelling a search for new treatments. As aspirin exhibits a well‐supported chemopreventive effect on common cancers, researchers have proposed using aspirin as a potential preventive and adjuvant agent for cholangiocarcinoma. In the present review of the literature, we provide a background on cholangiocarcinoma and potential mechanisms of action underlying the anticancer effect of aspirin. Although the exact mode of action remains unclear, multiple downstream effects of aspirin may interfere with cholangiocarcinogenesis, tumour growth and metastasis—including inhibiting the COX‐2 pathway, preventing platelet aggregation and modulating certain proteins and signalling. This review also summarises evidence to support the chemopreventive effects of aspirin on common cancers, particularly colorectal cancer and discusses studies that report a positive outcome of aspirin in cholangiocarcinoma. Regular use of aspirin is associated with a reduced incidence of colorectal cancers as well as cholangiocarcinomas, and improved survival. Aspirin thus appears to play a role in the primary prevention and treatment of cholangiocarcinoma. However, further studies are needed to confirm these benefits and to establish a cause‐and‐effect relationship.

show abstract

Association Between Aspirin and Cholangiocarcinoma in a Large Asian Cohort

et al. 2020

View full text Add to dashboard Cite

show abstract

Effects of aspirin and non-steroidal anti-inflammatory drugs on the risk of cholangiocarcinoma: a meta-analysis

Cited by 13 publications

References 35 publications

<p>Prognosis Value of Platelet Counts, Albumin and Neutrophil-Lymphocyte Ratio of Locoregional Recurrence in Patients with Operable Head and Neck Squamous Cell Carcinoma</p>

<p>Prognosis Value of Platelet Counts, Albumin and Neutrophil-Lymphocyte Ratio of Locoregional Recurrence in Patients with Operable Head and Neck Squamous Cell Carcinoma</p>

A potential role for aspirin in the prevention and treatment of cholangiocarcinoma

Association Between Aspirin and Cholangiocarcinoma in a Large Asian Cohort

Contact Info

Product

Resources

About