Substance Use (Alcohol, Areca Nut and Cigarette) Is Associated with Poor Prognosis of Esophageal Squamous Cell Carcinoma
Journal
PLoS ONE
Journal Volume
8
Journal Issue
2
Pages
e55834
Date Issued
2013
Author(s)
Wu I.-C.
Wu C.-C.
Lu C.-Y.
Hsu W.-H.
Wu M.-C.
Lee J.-Y.
Chou S.-H.
Chou Y.-P.
Wu D.-C.
Wu M.-T.
Abstract
Background: Few studies have reported the association between lifestyle factors and prognosis of esophageal squamous cell carcinoma (ESCC) and among these, the effects of habitual areca nut chewing have never been examined. Methodology/Principal Findings: Data from 718 pathology-proven ESCC patients recruited in a multicenter hospital-based case-control study between 2000 and 2008 in Taiwan were analyzed. Clinical and lifestyle information were obtained by chart review and questionnaire survey. Death was confirmed using the National Death Index. The mean age at diagnosis was 59.8 years and 506 (70.5%) patients presented with stage III or IV diseases. The overall 1- and 5-year survival rates were 41.8% and 9.75% respectively. In addition to clinical stage, habitual alcohol drinking was found to be the strongest predictor for ESCC survival, followed by areca chewing and smoking. Compared with non-users, patients who regularly used all three substances (alcohol, areca nut, and cigarette) had 1.52 times the risk of early death (adjusted hazard ratio = 1.52, 95% CI = 1.02-2.27, p = 0.04). In addition, the more the number of substances used, the worse the prognosis of ESCC (adjusted p for trend = 0.01). Conclusions/Significance: Our study found that indulgence in more substances is a significant predictor of ESCC survival. Further mechanistic studies are necessary to elucidate how these substances lead to an adverse outcome. ? 2013 Wu et al.
SDGs
Other Subjects
alcohol; adult; aged; alcohol consumption; article; betel nut; cancer mortality; cancer prognosis; cancer staging; clinical study; controlled study; disease association; drinking behavior; esophageal squamous cell carcinoma; feeding behavior; female; health survey; hospital based case control study; human; lifestyle; major clinical study; male; medical record review; onset age; overall survival; risk assessment; risk factor; smoking; survival prediction; survival rate; Taiwan; trend study; Aged; Carcinoma, Squamous Cell; Case-Control Studies; Esophageal Neoplasms; Female; Humans; Life Style; Male; Middle Aged; Prognosis; Proportional Hazards Models; Questionnaires; Risk Factors; Substance-Related Disorders; Survival Analysis
Type
journal article