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Meta-Analysis
. 2023 Jan;79(1):39-61.
doi: 10.1007/s00228-022-03414-y. Epub 2022 Nov 5.

Does aspirin reduce the incidence, recurrence, and mortality of hepatocellular carcinoma? A GRADE-assessed systematic review and dose-response meta-analysis

Shaodi Ma #  1 , Guangbo Qu #  1 , Chenyu Sun  2 , Haixia Liu  1 , Yuemeng Jiang  3 , Ning Li  1 , Birong Wu  1 , Juan Gao  1 , Linya Feng  1 , Peng Xie  1 , Weihang Xia  1 , Na Hyun Kim  2 , Scott Lowe  4 , Rachel Bentley  4 , Yike Zhu  5 , Qin Zhou  6 , Yehuan Sun  7   8
Affiliations
Meta-Analysis

Does aspirin reduce the incidence, recurrence, and mortality of hepatocellular carcinoma? A GRADE-assessed systematic review and dose-response meta-analysis

Shaodi Ma et al. Eur J Clin Pharmacol. 2023 Jan.

Abstract

Purpose: Aspirin has been suggested to reduce the risk of cancer. However, previous studies have been inconsistent regarding the relationship between aspirin use and the risk of occurrence of hepatocellular carcinoma (HCC). The purpose of this study was to assess the effect of aspirin on clinical outcomes in patients with HCC in a meta-analysis and to explore the possible dose-response relationship.

Methods: A systematic literature search was conducted in 10 electronic databases and 4 registries. The combined hazard ratios (HRs) were calculated using a random-effects model with 95% confidence interval (CIs) to assess the effect of aspirin on the risk of HCC. Relevant subgroup analyses and sensitivity analyses were performed.

Results: The results show that aspirin use correlated with lower incidence of HCC (HR: 0.75, 95% CI: 0.71-0.80), decreased risk of HCC recurrence (HR: 0.79, 95% CI: 0.65-0.96), and reduced mortality (HR: 0.72, 95% CI: 0.60-0.87). The results of the subgroup analysis showed that aspirin use was consistently associated with reduced incidence of HCC across different regions, study designs, and populations. A linear relationship was found for both dosage and duration of aspirin use. An increased of bleeding with aspirin use among patients was also observed (HR 1.10, 95% CI: 1.02-1.20).

Conclusions: This meta-analysis found that aspirin use was independently associated with a reduced risk of HCC incidence, recurrence, and death. Furthermore, aspirin use influenced HCC occurrence in a dose-dependent and duration-dependent manner. However, an increased risk of bleeding with aspirin use was noted.

Keywords: Aspirin; Bleeding risk; Hepatocellular carcinoma; Meta-analysis.

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References

    1. Sung H, Ferlay J, Siegel RL et al (2021) Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 71(3):209–249. https://doi.org/10.3322/caac.21660 - DOI
    1. Craig AJ, von Felden J, Garcia-Lezana T et al (2020) Tumour evolution in hepatocellular carcinoma. Nat Rev Gastroenterol Hepatol 17(3):139–152. https://doi.org/10.1038/s41575-019-0229-4 - DOI
    1. Chen M, Hu J, Cao J et al (2020) comprehensive consideration before the decision-making of the systemic treatment in patients with advanced hepatocellular carcinoma. Liver Cancer 9(2):221–222. https://doi.org/10.1159/000502775 - DOI
    1. Vogel A, Saborowski A (2020) Current strategies for the treatment of intermediate and advanced hepatocellular carcinoma. Cancer Treat Rev 82:101946. https://doi.org/10.1016/j.ctrv.2019.101946 - DOI
    1. Michiels JJ (2003) Platelet-mediated microvascular inflammation and thrombosis in thrombocythemia vera: a distinct aspirin-responsive arterial thrombophilia, which transforms into a bleeding diathesis at increasing platelet counts. Pathol Biol (Paris) 51(3):167–75. https://doi.org/10.1016/s0369-8114(03)00038-5

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