{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T11:58:17Z","timestamp":1768564697024,"version":"3.49.0"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2021,7,20]],"date-time":"2021-07-20T00:00:00Z","timestamp":1626739200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,7,20]],"date-time":"2021-07-20T00:00:00Z","timestamp":1626739200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec>\n            <jats:title>Background and Aims<\/jats:title>\n            <jats:p>Biliary tract cancer (BTC) is rare and has limited treatment options. We aimed to examine aspirin use on cancer\u2010specific survival in various BTC subtypes, including gallbladder cancer, ampulla of Vater cancer, and cholangiocarcinoma.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Approach and Results<\/jats:title>\n            <jats:p>Nationwide prospective cohort of newly diagnosed BTC between 2007 and 2015 were included and followed until December 31, 2017. Three nationwide databases, namely the Cancer Registration, National Health Insurance, and Death Certification System, were used for computerized data linkage. Aspirin use was defined as one or more prescriptions, and the maximum defined daily dose was used to evaluate the dose\u2013response relationship. Cox\u2019s proportional hazards models were applied for estimating HRs and 95% CIs. Analyses accounted for competing risk of cardiovascular deaths, and landmark analyses to avoid immortal time bias were performed. In total, 2,519 of patients with BTC were exposed to aspirin after their diagnosis (15.7%). After a mean follow\u2010up of 1.59\u00a0years, the 5\u2010year survival rate was 27.4%. The multivariate\u2010adjusted HR for postdiagnosis aspirin users, as compared with nonusers, was 0.55 (95% CI: 0.51 to 0.58) for BTC\u2010specific death. Adjusted HRs for BTC\u2010specific death were 0.53 (95% CI: 0.48 to 0.59) and 0.42 (95% CI: 0.31 to 0.58) for \u2264 1 and &gt; 1 maximum defined daily dose, respectively, and showed a dose\u2013response trend (<jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0&lt;\u00a00.001; nonusers as a reference). Cancer\u2010specific mortality was lower with postdiagnosis aspirin use in patients with all major BTC subtypes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>The nationwide study revealed that postdiagnosis aspirin use was associated with improved BTC\u2010specific mortality of various subtypes. The findings suggest that additional randomized trials are required to investigate aspirin\u2019s efficacy in BTC.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.31879","type":"journal-article","created":{"date-parts":[[2021,5,4]],"date-time":"2021-05-04T02:29:29Z","timestamp":1620095369000},"page":"1994-2006","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":16,"title":["Postdiagnosis Aspirin Use Associated With Decreased Biliary Tract Cancer\u2013Specific Mortality in a Large Nationwide Cohort"],"prefix":"10.1097","volume":"74","author":[{"given":"Shu\u2010Fen","family":"Liao","sequence":"first","affiliation":[{"name":"Institute of Clinical Medicine,National Yang Ming Chiao Tung University,Taipei,Taiwan"},{"name":"Institute of Biomedical Sciences,Academia 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Immunoepidemiology Branch,Division of Cancer Epidemiology and Genetics,National Cancer Institute,National Institutes of Health,Rockville,MD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu\u2010Han","family":"Huang","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine,National Yang Ming Chiao Tung University,Taipei,Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chi","family":"Chan","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine,National Yang Ming Chiao Tung University,Taipei,Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Huang","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine,National Yang Ming Chiao Tung University,Taipei,Taiwan"},{"name":"Faculty of Medicine,National Yang Ming Chiao Tung University,Taipei,Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Po\u2010Chun","family":"Liu","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine,National Yang Ming Chiao Tung University,Taipei,Taiwan"},{"name":"Faculty of Medicine,National Yang Ming Chiao Tung University,Taipei,Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yen\u2010Ju","family":"Chen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine,National Yang Ming Chiao Tung University,Taipei,Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca J.","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Faculty of Medicine,National Yang Ming Chiao Tung University,Taipei,Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ching\u2010Po","family":"Huang","sequence":"additional","affiliation":[{"name":"Faculty of Medicine,National Yang Ming Chiao Tung University,Taipei,Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheng\u2010Nan","family":"Lu","sequence":"additional","affiliation":[{"name":"Division of Hepatogastroenterology,Department of Internal Medicine,Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine,Kaohsiung,Taiwan"},{"name":"Division of Hepatogastroenterology,Department of Internal Medicine,Chiayi Chang Gung Memorial Hospital,Chiayi,Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chien\u2010Jen","family":"Chen","sequence":"additional","affiliation":[{"name":"Genomics Research Center,Academia Sinica,Taipei,Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen\u2010Yang","family":"Shen","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Sciences,Academia 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