Could aspirin be a lifesaver for prostate cancer patients in prostate cancer-specific mortality?: an update systematic review and meta-analysis
Tóm tắt
Currently, clinical studies on the prognosis of prostate cancer (PC) taking aspirin were developing, but the precise mechanism of aspirin on tumor cells was still unclear. In addition, the conclusion that aspirin can improve the prognosis of PC patients continues to be controversial. Therefore, we collected comprehensive literatures and performed our study to explore the prognostic effect of aspirin on PC. A comprehensive literature search was performed in April 2019 based on PUBMED. EMBASE. Hazard Ratio (HR) as well as its 95% confidence interval (CIs) for prostate cancer specific mortality (PCSM) was extracted from eligible studies. A total of 10 eligible articles were used in our study. The pooled results showed that PC patients who used aspirin or taking aspirin did not have lower PCSM than those who had not used (HR =0.89, 95% CI: 0.73–1.08, P>0.05). In subgroup analysis, we found that taking aspirin before diagnosis of prostate cancer and taking aspirin after diagnosis of prostate cancer did not have significant association with PCSM. (pre-diagnostic use, HR = 0.88, 95% CI: 0.72–1.06; post-diagnosis use, HR = 0.88, 95% CI: 0.67–1.17). In addition, we found no significant association between aspirin use or its duration and the risk of PCSM. Another important result demonstrated that aspirin use was not associated with risk of PSCM in either high risk (T ≥ 3 and/or Gleason score ≥ 8) or low risk PC patients(low-risk PC, HR = 1.05, 95% CI: 0.81–1.35; high-risk PC, HR = 0.97, 95% CI: 0.75–1.24). Our results demonstrated that there was no significant association between aspirin use and the risk of PCSM. At the same time, the dosage and duration of aspirin use had no statistical influence on the risk of PCSM in high/low risk PC. Further studies are needed to confirm the findings.
Tài liệu tham khảo
Chan TA. Nonsteroidal anti-inflammatory drugs, apoptosis, and colon-cancer chemoprevention. Lancet Oncol. 2002;3(3):166–74.
Liu XH, et al. Inhibition of cyclooxygenase-2 suppresses angiogenesis and the growth of prostate cancer in vivo. J Urol. 2000;164(3):820–5.
Nash GF, et al. Platelets and cancer. Lancet Oncol. 2002;3(7):425–30.
Downer MK, et al. Regular aspirin use and the risk of lethal prostate cancer in the physicians’ health study. Eur Urol. 2017;72(5):821–7.
Assayag J, Pollak MN, Azoulay L. The use of aspirin and the risk of mortality in patients with prostate cancer. J Urol. 2015;193(4):1220–5.
Liu Y, et al. Effect of aspirin and other non-steroidal anti-inflammatory drugs on prostate cancer incidence and mortality: a systematic review and meta-analysis. BMC Med. 2014;12(1):55.
Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses [J]. Eur J Epidemiol. 2010;25(9):603–5.
Higgins JPT, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21(11):1539–58.
Bax L, et al. More than numbers: the power of graphs in meta-analysis. Am J Epidemiol. 2009;169(2):249–55.
Seagroatt V, Stratton I. Bias in meta-analysis detected by a simple, graphical test. Test had 10% false positive rate. BMJ. 1997;316(7129):469–71.
Flahavan EM, et al. A cohort study investigating aspirin use and survival in men with prostate cancer. Ann Oncol. 2014;25(1):154–9.
Hurwitz LM, et al. Aspirin and non-aspirin NSAID use and prostate cancer incidence, mortality, and case fatality in the atherosclerosis risk in communities study. Cancer Epidemiol Biomark Prev. 2019;28(3):563–9.
Choe KS, et al. Aspirin use and the risk of prostate cancer mortality in men treated with prostatectomy or radiotherapy. J Clin Oncol. 2012;30(28):3540–4.
Jacobs EJ, et al. Daily aspirin use and prostate cancer-specific mortality in a large cohort of men with nonmetastatic prostate cancer. J Clin Oncol Off J Am Soc Clin Oncol. 2014;32(33):3716–22.
Zhou CK, et al. Do aspirin and other NSAIDs confer a survival benefit in men diagnosed with prostate cancer? A pooled analysis of NIH-AARP and PLCO cohorts. Cancer Prev Res. 2017;10(7):410–20.
Rothwell PM, et al. Effect of daily aspirin on long-term risk of death due to cancer: analysis of individual patient data from randomised trials. Mdica. 2010;377(9759):31–41.
Stock DC, et al. Effects of non-selective non-steroidal anti-inflammatory drugs on the aggressiveness of prostate cancer. Prostate. 2008;68(15):1655–65.
Veitonmäki T, et al. Use of non-steroidal anti-inflammatory drugs and prostate cancer survival in the finnish prostate cancer screening trial. Prostate. 2015;75(13):1394–402.
Gupta S, et al. Over-expression of cyclooxygenase-2 in human prostate adenocarcinoma. Prostate. 2015;42(1):73–8.
Yoshimura R, et al. Expression of cyclooxygenase-2 in prostate carcinoma. Cancer. 2015;89(3):589–96.
Jacobs CD, et al. Aspirin improves outcome in high risk prostate cancer patients treated with radiation therapy. Cancer Biol Ther. 2014;15(6):699–706.
Fan LL, et al. Aspirin exposure and mortality risk among prostate cancer patients: a systematic review and meta-analysis. Biomed Res Int. 2019;2019:1–15.