Association between continuous cessation or reduction of drinking alcohol and improvement of multiple dysplastic lesions in patients with esophageal squamous cell carcinoma after endoscopic resection.

Autor: Hori K; Department of Gastroenterology and Hepatology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan.; Department of Internal Medicine, Tsuyama Chuo Hospital, Tsuyama, Japan., Katada C; Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, 54 Kawaharacho Syhogoin Sakyo, Kyoto, 606-8507, Japan. ckatada@kuhp.kyoto-u.ac.jp.; Department of Real World Data Research and Development, Graduate School of Medicine, Kyoto University, 54 Kawaharacho Syhogoin Sakyo, Kyoto, 606-8507, Japan. ckatada@kuhp.kyoto-u.ac.jp., Okada H; Department of Gastroenterology and Hepatology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan.; Department of Internal Medicine, Japanese Red Cross Society Himeji Hospital, Himeji, Japan., Katagiri A; Department of Medicine, Division of Gastroenterology, Showa University Hospital, Tokyo, Japan., Matsuo Y; Department of Gastroenterology, St. Marianna University School of Medicine, Kawasaki, Japan., Yokoyama T; Department of Health and Promotion, National Institute of Public Health, Wako, Japan., Yano T; Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan., Suzuki H; Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan., Shimizu Y; Department of Gastroenterology, Hokkaido University Graduate School of Medicine, Sapporo, Japan., Furue Y; Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Japan., Nakanishi H; Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan., Koike T; Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan., Takizawa K; Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan.; Department of Endoscopy, Koyukai Shin-Sapporo Hospital, Hokkaido, Japan., Hirao M; Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan., Yoshii T; Department of Gastroenterology, Kanagawa Cancer Center, Yokohama, Japan., Yamanouchi T; Department of Gastroenterology, Kumamoto Regional Medical Center, Kumamoto, Japan., Kawakubo H; Department of Surgery, Kawasaki Municipal Kawasaki Hospital, Kawasaki, Japan., Kobayashi N; Department of Gastroenterology, Tochigi Cancer Center, Utsunomiya, Japan., Shimoda T; Division of Diagnostic Pathology, Shizuoka Cancer Center, Shizuoka, Japan., Ochiai A; Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Japan., Ishikawa H; Department of Molecular-Targeting Cancer Prevention, Kyoto Prefectural University of Medicine, Kyoto, Japan., Yokoyama A; Clinical Research Unit, National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Japan., Muto M; Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, 54 Kawaharacho Syhogoin Sakyo, Kyoto, 606-8507, Japan.
Jazyk: angličtina
Zdroj: Esophagus : official journal of the Japan Esophageal Society [Esophagus] 2024 Jan; Vol. 21 (1), pp. 31-40. Date of Electronic Publication: 2023 Dec 09.
DOI: 10.1007/s10388-023-01033-9
Abstrakt: Background: Multiple development of squamous cell carcinoma (SCC) in the upper aerodigestive tract has been explained by the 'field cancerization phenomenon' associated with alcohol drinking. Squamous dysplastic lesion is clinically visualised as a Lugol-voiding lesion (LVL) by chromoendoscopy. Whether cessation or reduction of alcohol drinking improves multiple LVL and reduces the risk of field cancerization has not been elucidated.
Methods: We analysed 330 patients with newly diagnosed superficial esophageal SCC (ESCC) enrolled in the cohort study. The grade of LVL was assessed in all patients every 6 months. We instructed the patients to stop smoking and drinking and recorded their drinking and smoking status every 6 months.
Results: Among 330 patients, we excluded 98 with no LVL or no drinking habit. Of the remaining 232 patients, 158 continuously ceased or reduced their drinking habit. Patients who ceased or reduced their drinking habit significantly showed improvement in the grade of LVL. Multivariate analysis showed that continuous cessation or reduction of drinking habit improved the grade of LVL (hazard ratio [HR] = 8.5, 95% confidence interval [CI] 1.7-153.8, p = 0.0053). Higher grade of LVL carried a high risk of multiple ESCC and head and neck SCC (HNSCC) (HR = 3.7, 95% CI 2.2-6.4, p < 0.0001). Improvement in LVL significantly decreased the risk of multiple ESCC and HNSCC (HR = 0.2, 95% CI 0.04-0.7, p = 0.009).
Conclusions: This is the first report indicating that field cancerization was reversible and cessation or reduction of drinking alcohol could prevent multiple squamous dysplastic lesion and multiple ESCC and HNSCC development.
Clinical Trials Registry Number: UMIN000001676.
(© 2023. The Author(s) under exclusive licence to The Japan Esophageal Society.)
Databáze: MEDLINE
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