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Katada C, Yokoyama T, Yano T, Suzuki H, Furue Y, Yamamoto K, Doyama H, Koike T, Tamaoki M, Kawata N, Hirao M, Kawahara Y, Ogata T, Katagiri A, Yamanouchi T, Kiyokawa H, Kawakubo H, Konno M, Yokoyama A, Ohashi S, Kondo Y, Kishimoto Y, Kano K, Mure K, Hayashi R, Ishikawa H, Yokoyama A, Muto M. Alcohol consumption, multiple Lugol-voiding lesions, and field cancerization. DEN OPEN 2024; 4:e261. [PMID: 37409321 PMCID: PMC10318126 DOI: 10.1002/deo2.261] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/02/2023] [Accepted: 06/12/2023] [Indexed: 07/07/2023]
Abstract
The development of multiple squamous cell carcinomas (SCC) in the upper aerodigestive tract, which includes the oral cavity, pharynx, larynx, and esophagus, is explained by field cancerization and is associated with alcohol consumption and cigarette smoking. We reviewed the association between alcohol consumption, multiple Lugol-voiding lesions, and field cancerization, mainly based on the Japan Esophageal Cohort study. The Japan Esophageal Cohort study is a prospective cohort study that enrolled patients with esophageal SCC after endoscopic resection. Enrolled patients received surveillance by gastrointestinal endoscopy every 6 months and surveillance by an otolaryngologist every 12 months. The Japan Esophageal Cohort study showed that esophageal SCC and head and neck SCC that developed after endoscopic resection for esophageal SCC were associated with genetic polymorphisms related to alcohol metabolism. They were also associated with Lugol-voiding lesions grade in the background esophageal mucosa, the score of the health risk appraisal model for predicting the risk of esophageal SCC, macrocytosis, and score on alcohol use disorders identification test. The standardized incidence ratio of head and neck SCC in patients with esophageal SCC after endoscopic resection was extremely high compared to the general population. Drinking and smoking cessation is strongly recommended to reduce the risk of metachronous esophageal SCC after treatment of esophageal SCC. Risk factors for field cancerization provide opportunities for early diagnosis and minimally invasive treatment. Lifestyle guidance of alcohol consumption and cigarette smoking for esophageal precancerous conditions, which are endoscopically visualized as multiple Lugol-voiding lesions, may play a pivotal role in decreasing the incidence and mortality of esophageal SCC.
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Affiliation(s)
- Chikatoshi Katada
- Department of Therapeutic OncologyGraduate School of Medicine, Kyoto UniversityKyotoJapan
| | - Tetsuji Yokoyama
- Department of Health and PromotionNational Institute of Public HealthSaitamaJapan
| | - Tomonori Yano
- Department of Gastroenterology and EndoscopyNational Cancer Center Hospital EastChibaJapan
| | | | - Yasuaki Furue
- Department of GastroenterologyKitasato University School of MedicineKanagawaJapan
| | - Keiko Yamamoto
- Division of EndoscopyHokkaido University HospitalHokkaidoJapan
| | - Hisashi Doyama
- Department of GastroenterologyIshikawa Prefectural Central HospitalIshikawaJapan
| | - Tomoyuki Koike
- Division of GastroenterologyTohoku University Graduate School of MedicineMiyagiJapan
| | - Masashi Tamaoki
- Department of Therapeutic OncologyGraduate School of Medicine, Kyoto UniversityKyotoJapan
| | - Noboru Kawata
- Division of EndoscopyShizuoka Cancer CenterShizuokaJapan
| | - Motohiro Hirao
- Department of SurgeryNational Hospital Organization Osaka National HospitalOsakaJapan
| | - Yoshiro Kawahara
- Department of Practical Gastrointestinal EndoscopyFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityOkayamaJapan
| | - Takashi Ogata
- Department of GastroenterologyKanagawa Cancer CenterKanagawaJapan
| | - Atsushi Katagiri
- Department of Medicine, Division of GastroenterologyShowa University HospitalTokyoJapan
| | | | - Hirofumi Kiyokawa
- Division of Gastroenterology, Department of Internal MedicineSt. Marianna University School of MedicineKanagawaJapan
| | - Hirofumi Kawakubo
- Department of SurgeryKawasaki Municipal Kawasaki HospitalKanagawaJapan
| | - Maki Konno
- Department of GastroenterologyTochigi Cancer CenterTochigiJapan
| | - Akira Yokoyama
- Department of Therapeutic OncologyGraduate School of Medicine, Kyoto UniversityKyotoJapan
| | - Shinya Ohashi
- Department of Therapeutic OncologyGraduate School of Medicine, Kyoto UniversityKyotoJapan
| | - Yuki Kondo
- Department of Therapeutic OncologyGraduate School of Medicine, Kyoto UniversityKyotoJapan
| | - Yo Kishimoto
- Department of Otolaryngology‐Head and Neck SurgeryKyoto University HospitalKyotoJapan
| | - Koichi Kano
- Department of Otorhinolaryngology‐Head and Neck SurgeryKitasato University School of MedicineKanagawaJapan
| | - Kanae Mure
- Department of Public HealthWakayama Medical University School of MedicineWakayamaJapan
| | - Ryuichi Hayashi
- Department of Head and Neck SurgeryNational Cancer Center Hospital EastChibaJapan
| | - Hideki Ishikawa
- Department of Molecular‐Targeting PreventionKyoto Prefectural University of MedicineKyotoJapan
| | - Akira Yokoyama
- Clinical Research UnitNational Hospital Organization Kurihama Medical and Addiction CenterKanagawaJapan
| | - Manabu Muto
- Department of Therapeutic OncologyGraduate School of Medicine, Kyoto UniversityKyotoJapan
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Du J, Bao Z, Liang T, Zhao H, Zhao J, Xu R, Wang X. Risk factors for metachronous esophageal squamous cell carcinoma after endoscopic or surgical resection of esophageal carcinoma: a systematic review and meta-analysis. Front Oncol 2023; 13:1241572. [PMID: 37781208 PMCID: PMC10540085 DOI: 10.3389/fonc.2023.1241572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 08/21/2023] [Indexed: 10/03/2023] Open
Abstract
Background early-stage esophageal carcinoma (EC) patients lack typical clinical signs and symptoms and are often diagnosed and treated at a late stage, leading to a poor prognosis and a high incidence of metachronous esophageal squamous cell carcinoma (MESCC) and second primary carcinoma (SPC). The aims of the review were to identify and quantify risk factors for MESCC and analysis location of SPC in postoperative patients with EC; to predict incidence of MESCC over follow-up time. Methods an electronic search of studies reporting potential risk factors, the incidence of MESCC, and the location of SPC were performed on PubMed, Web of Science, Cochrane Library, Embase, and Scopus from inception to 10 November 2022. The Newcastle-Ottawa scale was used to assess the study quality, and the qualitative strength of evidence rating of all items was provided. The meta-regression model was used to predict the incidence of MESCC over follow-up time, the location distribution of SPC was presented using clustered column chart, while the publication bias was assessed using funnel plots and Egger's test. Results smoking, age, history of multiple other cancer, and Lugol-voiding lesions (LVLs) were determined to be the risk factors of MESCC. LVLs were qualitatively determined as "definite" and the history of multiple other cancer as "likely." The overall pooled MESCC incidence was 20.3% (95% CI: 13.8% to 26.8%), with an increase of 0.20% for each additional year of follow-up. The head and neck were the most common locations for SPC, followed by the esophagus. Conclusion timely investigating the age of patients, previous history of cancer and monitoring the number of LVLs in the first 5 years after operation are of great significance to identify high-risk populations of MESCC for timely medical care. Education and behavior correction about smoking are advocated. Tumor markers should be regularly detected in the head and neck, esophagus, and stomach. Endoscopic resection was associated with a higher incidence of MESCC, which provided a reference for doctors to choose the removal method. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022377030.
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Affiliation(s)
- Jie Du
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Zhixian Bao
- The First Clinical Medical College, Lanzhou University, Lanzhou, China
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China
- Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China
| | - Tianhu Liang
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Hongmei Zhao
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Junxian Zhao
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Ruipu Xu
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
- Talent Service Center, Gansu Provincial Health Commission, Lanzhou, China
| | - Xiaohui Wang
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
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Katada C, Yokoyama T, Mure K, Doyama H, Nakanishi H, Shimizu Y, Yamamoto K, Furue Y, Tamaoki M, Koike T, Kawahara Y, Kiyokawa H, Konno M, Yokoyama A, Ohashi S, Ishikawa H, Yokoyama A, Muto M. Risk factors for the development of second primary esophageal squamous-cell carcinoma after endoscopic resection for esophageal squamous-cell carcinoma according to genetic polymorphisms related to alcohol and nicotine metabolism. Jpn J Clin Oncol 2023; 53:774-780. [PMID: 37370215 DOI: 10.1093/jjco/hyad070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Multiple development of esophageal squamous-cell carcinoma is explained by field cancerization and is associated with alcohol consumption and smoking. We investigated the association between the development of second primary esophageal squamous-cell carcinoma after endoscopic resection for esophageal squamous-cell carcinoma and genetic polymorphisms related to alcohol and nicotine metabolism. METHODS The study group comprised 56 patients with esophageal squamous-cell carcinoma after endoscopic resection. The main variables were the following: (i) cumulative incidence and total number of second primary esophageal squamous-cell carcinoma according to genetic polymorphisms in alcohol dehydrogenase 1B, aldehyde dehydrogenase 2 and cytochrome P450 2A6; and (ii) risk factors of second primary esophageal squamous-cell carcinoma identified using a multivariate Cox proportional-hazards model. The frequencies of alcohol dehydrogenase 1B, aldehyde dehydrogenase 2 and cytochrome P450 2A6 genetic polymorphisms in the buccal mucosa were analyzed. RESULTS The median follow-up was 92.8 months (range: 2.7-134.2). Slow-metabolizing alcohol dehydrogenase 1B was associated with a higher 7-year cumulative incidence of second primary esophageal squamous-cell carcinoma (fast-metabolizing alcohol dehydrogenase 1B vs slow-metabolizing alcohol dehydrogenase 1B: 20.5% vs 71.4%, P = 0.006). Slow-metabolizing alcohol dehydrogenase 1B (relative risk [95% confidence interval]: 3.17 [1.49-6.73]), inactive aldehyde dehydrogenase 2 (2.17 [1.01-4.63]) and poorly-metabolizing cytochrome P450 2A6 (4.63 [1.74-12.33]) had a significantly higher total number of second primary esophageal squamous-cell carcinoma per 100 person-years. In the multivariate Cox proportional-hazards model, slow-metabolizing alcohol dehydrogenase 1B was a significant risk factor of the development of second primary esophageal squamous-cell carcinoma (hazard ratio 9.92, 95% confidence interval: 2.35-41.98, P = 0.0018). CONCLUSIONS Slow-metabolizing alcohol dehydrogenase 1B may be a significant risk factor for the development of second primary esophageal squamous-cell carcinoma. In addition, inactive aldehyde dehydrogenase 2 and poorly-metabolizing cytochrome P450 2A6 may be important factors.
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Affiliation(s)
- Chikatoshi Katada
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tetsuji Yokoyama
- Department of Health and Promotion, National Institute of Public Health, Wako, Japan
| | - Kanae Mure
- Department of Public Health, Wakayama Medical University School of Medicine, Wakayama, Japan
| | - Hisashi Doyama
- Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
| | - Hiroyoshi Nakanishi
- Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
| | - Yuichi Shimizu
- Division of Endoscopy, Hokkaido University Hospital, Sapporo, Japan
| | - Keiko Yamamoto
- Division of Endoscopy, Hokkaido University Hospital, Sapporo, Japan
| | - Yasuaki Furue
- Department of Gasroenterology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Masashi Tamaoki
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomoyuki Koike
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yoshiro Kawahara
- Department of Practical Gastrointestinal Endoscopy, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Hirofumi Kiyokawa
- Division of Gastroenterology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Maki Konno
- Department of Gastroenterology, Tochigi Cancer Center, Utsunomiya, Japan
| | - Akira Yokoyama
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shinya Ohashi
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hideki Ishikawa
- Department of Molecular-Targeting Prevention, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Akira Yokoyama
- Clinical Research Unit, National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Japan
| | - Manabu Muto
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Desai V, Lamba W, de Almeida J, Goldstein D. Approach and Management of Alcohol Withdrawal Syndrome in Operative Head and Neck Cancer Patients. Otolaryngol Head Neck Surg 2023; 168:1258-1260. [PMID: 36841965 DOI: 10.1002/ohn.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 09/04/2022] [Indexed: 02/27/2023]
Abstract
Postoperative head and neck cancer patients are at increased risk for alcohol withdrawal syndrome. Literature has shown that in this patient population, alcohol withdrawal is associated with an increase in postoperative medical and surgical complications, length of hospitalization, and hospital-related costs. Harm reduction and addiction medicine philosophies can reduce morbidity and mortality, but have not been fully validated in perioperative surgical management for head and neck cancer. This commentary synthesizes key principles of addiction medicine and current strategies that Otolaryngology-Head and Neck Surgery surgeons can consider in their perioperative assessment and management of alcohol withdrawal syndrome in their patients.
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Affiliation(s)
- Veeral Desai
- Faculty of Medicine, Queen's University, Kingston, Canada
| | - Wiplove Lamba
- Department of Psychiatry, Sinai Health Systems, Toronto, Ontario, Canada
| | - John de Almeida
- Department of Otolaryngology-Head and Neck Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - David Goldstein
- Department of Otolaryngology-Head and Neck Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
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Bandeira CM, Almeida AÁ, Alves MGO, Pascoal MBN, Chagas JFS, Neto MB, de Barros PP, Nunes FD, Carta CFL, Almeida JD. The Fagerström and AUDIT Tests as Probable Screening Tools in Oral Cancer and Their Correlation with CYP1A1, GSTM1, GSTP1, and GSTT1 Gene Expression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3991. [PMID: 35409669 PMCID: PMC8997590 DOI: 10.3390/ijerph19073991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/26/2022] [Accepted: 03/01/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Cancer is currently a major public health problem worldwide, with a marked increase of about 70% in the number of expected diagnosed cases over the next two decades. The amount of tobacco and alcohol consumed is calculated based on the subjective information provided by the user. Tobacco exposure can be assessed using the Fagerström Test for Cigarette Dependence (FTCD) and alcohol consumption by the Alcohol Use Disorder Identification Test (AUDIT). MATERIALS AND METHODS Forty-eight subjects answered the Fagerström, and AUDIT tests and we studied them as likely screening tools for oral cancer and their correlation with the expression of CYP1A1, GSTM1, GSTP1, and GSTT1 genes by the RT-qPCR method. RESULTS There were significant differences in the AUDIT score and CYP1A1 expression between cancer and control groups. Participants in advanced stages, whether due to tumor size or regional metastasis, showed significant differences in the duration of tobacco use, FTCD, AUDIT score, and CYP1A1 expression when compared to patients in early stages. Among subjects without cancer, we found a significant correlation between participant age and GSTP1 expression. Furthermore, the expression of GSTP1 was significantly correlated with the number of cigarettes smoked per day, duration of tobacco use, and FTCD. CONCLUSIONS Questionnaires designed to evaluate the degree of tobacco and alcohol exposure and dependence combined with gene expression tests can be useful to assess the risk of developing oral cancer. Furthermore, raising the awareness of individuals regarding their degree of dependence and encouraging them to participate in cessation programs are important educational measures for the prevention of tobacco-related malignancies.
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Affiliation(s)
- Celso Muller Bandeira
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology of São José dos Campos, São Paulo State University (Unesp), São José dos Campos 12245-000, Brazil; (C.M.B.); (A.Á.A.); (P.P.d.B.); (C.F.L.C.)
- Faculdade de Ciências Médicas de São José dos Campos—Humanitas, São José dos Campos 12220-061, Brazil
| | - Adriana Ávila Almeida
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology of São José dos Campos, São Paulo State University (Unesp), São José dos Campos 12245-000, Brazil; (C.M.B.); (A.Á.A.); (P.P.d.B.); (C.F.L.C.)
| | - Mônica Ghislaine Oliveira Alves
- School of Medicine, Anhembi Morumbi University, São José dos Campos 12230-002, Brazil;
- Technology Research Center (NPT), Universidade Mogi das Cruzes, Mogi das Cruzes 08780-911, Brazil
| | - Maria Beatriz Nogueira Pascoal
- Department of Head and Neck Surgery, São Leopoldo Mandic College, Campinas 13045-755, Brazil; (M.B.N.P.); (J.F.S.C.)
- Department of Head and Neck Surgery, Hospital Municipal Doutor Mário Gatti, Campinas 13036-902, Brazil
| | - José Francisco Sales Chagas
- Department of Head and Neck Surgery, São Leopoldo Mandic College, Campinas 13045-755, Brazil; (M.B.N.P.); (J.F.S.C.)
| | - Morun Bernardino Neto
- Department of Basic Sciences and Environment, São Paulo University, São Paulo 12602-810, Brazil;
| | - Patrícia Pimentel de Barros
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology of São José dos Campos, São Paulo State University (Unesp), São José dos Campos 12245-000, Brazil; (C.M.B.); (A.Á.A.); (P.P.d.B.); (C.F.L.C.)
| | - Fábio Daumas Nunes
- Department of Oral Pathology, School of Dentistry, São Paulo University, São Paulo 05508-000, Brazil;
| | - Celina Faig Lima Carta
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology of São José dos Campos, São Paulo State University (Unesp), São José dos Campos 12245-000, Brazil; (C.M.B.); (A.Á.A.); (P.P.d.B.); (C.F.L.C.)
| | - Janete Dias Almeida
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology of São José dos Campos, São Paulo State University (Unesp), São José dos Campos 12245-000, Brazil; (C.M.B.); (A.Á.A.); (P.P.d.B.); (C.F.L.C.)
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