Impact of aspirin on biochemical recurrence of prostate cancer after robot assisted radical prostatectomy in a multicenter retrospective cohort study

Sci Rep. 2025 Jan 15;15(1):2025. doi: 10.1038/s41598-025-86521-x.

Abstract

This study evaluated the impact of aspirin on the biochemical recurrence (BCR) rate following robot-assisted radical prostatectomy (RARP) in patients. A database search identified patients who underwent RARP for pT2-3N0M0 disease at any of 25 centers between 2011 and 2022, categorized into aspirin (n = 350) and control groups (n = 5857). Adjustment by 1:1 propensity score matching (PSM) and Mahalanobis distance matching (MDM) created 350 matched pairs. The effect of aspirin on the BCR rate was evaluated by analysis of BCR-free survival. After PSM and MDM, the 3-year BCR-free rate was significantly better in the aspirin group (85.0%, 95% confidence interval [CI] 80.8-89.4) than in the control group (PSM, 74.5%, 95% CI 66.5-83.5, p = 0.021; MDM, 74.7%, 95% CI 66.3-84.3, p = 0.037). In the analysis of high-risk subgroups, patients in the aspirin group with an ISUP (International Society of Urological Pathology) grade ≥ 4 had a significantly lower recurrence rate in both matched groups (PSM, hazard ratio 0.44, 95% CI 0.22-0.88; MDM, hazard ratio 0.45, 95% CI 0.23-0.90). In conclusion, this study suggests that aspirin could enhance BCR-free survival post-RARP, especially in patients with higher ISUP grades.

Keywords: Aspirin; Biochemical recurrence; Prostate cancer; Robot-assisted laparoscopic radical prostatectomy; Survival rate.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aspirin* / pharmacology
  • Aspirin* / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local* / prevention & control
  • Propensity Score
  • Prostatectomy* / methods
  • Prostatic Neoplasms* / pathology
  • Prostatic Neoplasms* / surgery
  • Retrospective Studies
  • Robotic Surgical Procedures* / methods

Substances

  • Aspirin