Open AccessImpact of alcohol consumption on survival in patients with esophageal carcinoma: A large cohort with long‐term follow‐up
Author(s) -
Huang Qingyuan,
Luo Kongjia,
Yang Hong,
Wen Jing,
Zhang Shuishen,
Li Jinhui,
Ela Bella Amos,
Liu Qianwen,
Yang Fu,
Zheng Yuzhen,
Hu Ronggui,
Chen Junying,
Fu Jianhua
Publication year - 2014
Publication title -
cancer science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.035
H-Index - 141
eISSN - 1349-7006
pISSN - 1347-9032
DOI - 10.1111/cas.12552
Subject(s) - medicine , alcohol consumption , cohort , carcinoma , term (time) , oncology , overall survival , alcohol , survival analysis , consumption (sociology) , cohort study , surgery , biology , biochemistry , social science , physics , quantum mechanics , sociology
Alcohol is a well‐established cause of esophageal carcinoma, but its effect on survival is little known and contradictory. To clarify whether drinking is an independent predictor of survival in esophageal carcinoma, 2151 Chinese patients, receiving surgical resection from January 1997 to December 2008, were followed until March 2014. Cox proportional hazards analysis was applied to evaluate the prognostic effect of alcohol consumption. The median follow‐up was 64 months. The median overall survival ( OS ; 42 months) and disease‐free survival ( DFS ; 33 months) for never‐drinkers were significantly higher than ever‐drinkers (27 and 22 months, respectively). In the multivariate Cox model that was adjusted for age, weight loss, stage according to criteria set by the American Joint Committee on Cancer, radicality of surgery, adjuvant treatment, smoking status, and gender, the hazard ratios of ever‐drinking were 1.22 (1.06–1.41, P = 0.005) on OS , and 1.16 (1.01–1.34, P = 0.037) on DFS . The hazardous effect on OS and DFS of drinking grew statistically significantly in a dose‐dependent manner with increasing amount of alcohol consumption per day (both P ‐value for trend < 0.05). The predictive effect of drinking on OS ( P = 0.596) or DFS ( P = 0.207) was not significant in the subgroup with esophageal adenocarcinoma ( n = 195). The current study revealed that the survival is shortened, of those patients who consume alcohol before diagnosis of esophageal squamous cell carcinoma, which are not attributable to differences in stage, smoking status, and gender. Alcohol control should be emphasized to reduce mortality of esophageal carcinoma, and further outcome studies should include alcohol as a potential prognosticator.