Alcohol abstinence and risk assessment for second esophageal cancer in Japanese men after mucosectomy for early esophageal cancer

Akira Yokoyama, Chikatoshi Katada, Tetsuji Yokoyama, Tomonori Yano, Kazuhiro Kaneko, Ichiro Oda, Yuichi Shimizu, Hisashi Doyama, Tomoyuki Koike, Kohei Takizawa, Motohiro Hirao, Hiroyuki Okada, Takako Yoshii, Kazuo Konishi, Takenori Yamanouchi, Takashi Tsuda, Tai Omori, Nozomu Kobayashi, Haruhisa Suzuki, Satoshi TanabeKeisuke Hori, Norisuke Nakayama, Hirofumi Kawakubo, Hideki Ishikawa, Manabu Muto

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10 Citations (Scopus)

Abstract

Background Alcohol consumption combined with inactive aldehyde dehydrogenase-2 (ALDH2) and the presence of multiple esophageal Lugol-voiding lesions (LVLs; dysplasia) are strong predictors for multiple development of esophageal squamous cell carcinoma (ESCC) in East Asians. We invented a health risk appraisal (HRA) model for predicting the risk of ESCC based on drinking, smoking, dietary habits, and alcohol flushing, i.e., past or present facial flushing after drinking a glass of beer, a surrogate marker for inactive ALDH2. Methods Prospective follow-up examinations (median follow-up time, 50.3 months) were performed in 278 Japanese men after endoscopic mucosectomy for early ESCC (UMIN Clinical Trials Registry ID: UMIN000001676).Results Sixty-four subjects developed metachronous ESCC. A receiver operating characteristic curve showed that HRA scores ô12 best predicted the development of metachronous ESCC. The ESCC detection rate per 100 person-years was 9.8 in the high-HRA-score group (n = 104) and 4.5 in the low-HRA-score group (n = 174), and the risk of development of metachronous ESCC was higher in the high-HRA-score group than in the low-HRA-score group (adjusted hazard ratio: 2.00 [95% CI: 1.12-3.30]). Multiple LVLs was a very strong predictor of the development of metachronous SCC, but high HRA scores predicted it independently. The cumulative incidences of metachronous ESCC decreased after drinking cessation in the high-HRA-score drinker group (adjusted hazard ratio: 0.37 [0.14-0.97]). Conclusions Both the HRA model that included alcohol flushing and the multiple LVL grade predicted the development of metachronous ESCC in Japanese men after endoscopic mucosectomy for ESCC. Drinking cessation in the high-HRA-score drinker group reduced the rate of metachronous ESCC.

Original languageEnglish
Article numbere0175182
JournalPloS one
Volume12
Issue number4
DOIs
Publication statusPublished - 2017 Apr

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

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    Yokoyama, A., Katada, C., Yokoyama, T., Yano, T., Kaneko, K., Oda, I., Shimizu, Y., Doyama, H., Koike, T., Takizawa, K., Hirao, M., Okada, H., Yoshii, T., Konishi, K., Yamanouchi, T., Tsuda, T., Omori, T., Kobayashi, N., Suzuki, H., ... Muto, M. (2017). Alcohol abstinence and risk assessment for second esophageal cancer in Japanese men after mucosectomy for early esophageal cancer. PloS one, 12(4), [e0175182]. https://doi.org/10.1371/journal.pone.0175182