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Aspirin use is associated with a reduced risk of cholangiocarcinoma: a systematic review and meta-analysis

Authors Xiong JP, Xu WY, Bian J, Huang HC, Bai Y, Xu YY, Lu X, Zhao HT

Received 5 May 2018

Accepted for publication 6 August 2018

Published 1 October 2018 Volume 2018:10 Pages 4095—4104

DOI https://doi.org/10.2147/CMAR.S173197

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 3

Editor who approved publication: Professor Lu-Zhe Sun


Jianping Xiong,* Weiyu Xu,* Jin Bian, Hanchun Huang, Yi Bai, Yiyao Xu, Xin Lu, Haitao Zhao

Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, 100730, China

*These authors contributed equally to this work

Background: Aspirin has been revealed to probably decrease the risk of cholangiocarcinoma (CCC), which, nevertheless, is of controversy. To this end, a systematic review and meta-analysis was performed to investigate the above-described association.
Methods: We thoroughly searched PubMed, EMBASE, and ISI Web of Science for relevant studies published prior to October 2017, followed by random-effects model for calculation of pooled ORs and corresponding 95% CIs. Additionally, subgroup and sensitivity analyses were carried out to confirm whether the outcomes were stable.
Results: Nine articles, consisting of 12,535 CCC patients and 92,97,450 healthy controls, were enrolled in this study. We demonstrated a significantly decreased risk of CCC in those using aspirin, with studies being heterogeneous (OR=0.69; CI=0.43–0.94; I2=97.4%). Moreover, this relationship was detected only in case-control studies (OR=0.65; 95% CI=0.38–0.93), rather than cohort studies (OR=0.94; 95% CI=0.70–1.27). Besides, in separated analysis of intrahepatic CCC and extrahepatic CCC, aspirin was more strongly correlated with a declined risk of intrahepatic CCC (OR=0.33, 95% CI=0.26–0.39; I2=93.6%) than the risk of extrahepatic CCC (OR=0.56, 95% CI=0.41–0.73; I2=0%).
Conclusion: Collectively, the aspirin administration was correlated with a significant 31% decreased risk of CCC, particularly in the intrahepatic CCC.

Keywords: aspirin, cholangiocarcinoma, biliary tract neoplasms, meta-analysis

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