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Effects of Cyclooxygenase-2 Inhibitors on Gastrointestinal Malignancies: a Systematic Review and Meta-analysis

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Indian Journal of Surgical Oncology Aims and scope Submit manuscript

Abstract

Aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with a reduced risk of gastrointestinal malignancies, which is thought to be mediated mainly through the inhibition of cyclooxygenases-2 (COX-2). Due to the severe side effects of aspirin/NSAIDs, selective COX-2 inhibitors may be a more ideal choice. The objective is to evaluate the association of selective COX-2 inhibitors with gastrointestinal (GI) malignancies and premalignant lesions. We searched for published manuscripts evaluating the association between COX-2 inhibitors and GI malignancies or precancerous lesion. Two investigators independently abstracted the data; then, we conducted the analysis by Review Manager V.5.0; evaluation of effectiveness was performed by an intention to treat (ITT) method. Selective COX-2 inhibitors had no beneficial effects on the progression or regression of esophageal and gastric dysplasia (OR = 1.06, 95% CI 0.63–1.78, P = 0.83 for regression of esophageal dysplasia; OR = 1.06, 95% CI 0.58–1.91, P = 0.86 for progression of esophageal dysplasia; OR = 1.95, 95%CI 0.92–4.17, P = 0.08 for regression of gastric dysplasia; and OR = 0.99, 95%CI 0.68–1.43, P = 0.94 for progression of gastric dysplasia). There is no protective effect on colorectal cancer (OR = 0.89, 95% CI 0.77–1.03, P = 0.11), and the use could not improve the effect of chemoradiation (OR = 1.20, 95% CI 0.46–3.19, P = 0.71). This pooled analysis indicates no meaningful association between selective COX-2 inhibitors and GI malignancies.

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Authors and Affiliations

  1. Department of Gastroenterology, Tongji Hospital Affiliated to Tongji University, No. 389, Xincun Road, Shanghai, 200065, China

    Yuan-Xi Jiang, Ying Chen, Hui-hui Sun & Shu-chang Xu

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Correspondence to Shu-chang Xu.

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Jiang, YX., Chen, Y., Sun, Hh. et al. Effects of Cyclooxygenase-2 Inhibitors on Gastrointestinal Malignancies: a Systematic Review and Meta-analysis. Indian J Surg Oncol 13, 348–355 (2022). https://doi.org/10.1007/s13193-022-01547-1

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