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Comment & Response
March 19, 2020

Questionable Survival Benefit of Aspirin Use in Patients With Biliary Tract Cancer

Author Affiliations
  • 1Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Stanford University, Stanford, California
  • 2Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom
JAMA Oncol. Published online March 19, 2020. doi:10.1001/jamaoncol.2020.0122

To the Editor We read with interest the recent article by Jackson et al1 in JAMA Oncology on aspirin (acetylsalicylic acid) therapy in patients with biliary tract cancer (BTC). The authors conducted a retrospective cohort study using data from the UK’s Clinical Practice Research Datalink (CPRD) to test the hypothesis that aspirin’s anti-inflammatory mechanism may slow the spread of BTC. Analysis of overall survival was stratified by aspirin prescription and BTC subtype. The results are impressive, with adjusted mortality hazard ratios ranging from 0.44 to 0.71, all statistically significant. Kaplan-Meier survival estimates showed that median overall survival was barely reached in the aspirin cohort. These results were interpreted to show that the survival benefit of aspirin is on par with the current standard therapy for BTC.1 We commend the authors on this innovative, thought-provoking research.

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