Aspirin May Improve Liver Function After Embolization of HCC

Aspirin therapy can improve liver function and survival in patients who have received chemoembolization or transarterial embolization for hepatocellular carcinoma, according to a study published in the September issue of the American Journal of Roentgenology.

In a retrospective review of 304 patients, F. Edward Boas, M.D., Ph.D., of the Memorial Sloan Kettering Cancer Center in New York City, and colleagues assessed the mechanism by which aspirin improves survival of hepatocellular carcinoma patients when used in combination with transarterial embolization. Patients were divided into two groups on the basis of whether they took aspirin (42 patients) or not (262 patients) at the time of initial transarterial embolization.

The researchers found that patients who received aspirin experienced significantly lower bilirubin levels one day (0.9 versus 1.3; P < 0.001), one month (0.9 versus 1.2; P = 0.048), and one year (0.8 versus 1.0; P = 0.021) after embolization. The median overall survival period after initial embolization was longer for patients taking aspirin (57 versus 23 months; P = 0.008). Patients taking aspirin and those not taking aspirin were found to have no difference in initial response rate (88 versus 90 percent complete response or partial response; P = 0.59), median time to progression (6.2 versus 5.2 months; P = 0.42), initial site of progression (P = 0.71), or fraction of patients dying with disease progression (88 versus 89 percent; P = 1.00). Prior to embolization, the investigators noted no difference in main bilirubin levels between patient groups (0.8 versus 0.9 mg/dL; P = 0.11).

"Although the differences in liver function test results in the groups taking and not taking aspirin were small, standard biochemical liver function tests are insensitive to early cirrhotic changes," the authors write. "Small changes in biochemical liver function test results might underestimate the degree of liver injury after embolization."

Several authors disclosed financial ties to pharmaceutical companies, including Bayer.

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