Alcohol Consumption as a Major Risk Factor in the Development of Early Esophageal Cancer in Patients with Head and Neck Cancer.

Abstract

Objective To clarify the incidence of concomitant esophageal cancers in patients with head and neck cancer (HNC), and to investigate which risk factors are responsible for this association.Patients and Methods From 1994 to 2000, 134 patients with HNCunderwent upper gastrointestinal endoscopy using the 0.8% Lugol stain method to detect esophageal cancer. Acase-control study was designed to compare HNC patients with and without esophageal cancer. Logistic-regression analysis was used to obtain odds ratios of risk factors.Results Out of 134 patients with HNC, Lugol unstained area was detected in 42 patients. Biopsy specimens revealed squamous cell carcinoma in 17 (12.7%), dysplasia in 9 patients (6.6%), and normal in the others. Gastric carcinoma was also detected in 7 patients (5.2 %). The estimated depth of cancer invasion was mucosa in 9 patients, submucosa in 5 patients, and proper muscle or deeper in 3 patients. In the results of statistical analysis, high alcohol consumption of more than 75 g per day increased the risk of esophageal cancer (odds ratio: 20.2, p<0.01). Intake of hard liquor showed a high odds ratio (whisky: 28.7, p<0.05, shochu: 12.7, p<0.05). The amount of cigarette smoking was not related to this association. Conclusion High incidence of esophageal cancer was found in the patients with HNC. A high alcohol consumption level, and in particular hard liquor, participated in the development of esophageal cancer in the patients with HNC. But cigarette smoking was not related to this association. (Internal Medicine 40: 692-696, 2001)

Alcohol Drinking and Second Primary Cancer Risk in Patients with Upper Aerodigestive Tract Cancers: A Systematic Review and Meta-analysis of Observational Studies

“…The highest category of alcohol intake in the studies ranged from drinker status to more than or equal to 170 grams per day. In most studies (11)(12)(13)(14)(15)(16)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29), alcohol consumption was assessed after primary cancer diagnosis: before treatment in 3 studies (14-16), after treatment in 5 studies (11,22,(25)(26)(27), without information about treatment in 9 studies (12, 13, 19-21, 23, 24, 28, 29). Two studies did not specify when alcohol intake was assessed (17,18).…”

“…In the case of duplicate information, we used the publication providing the most adjusted risk estimation, up to date and complete data about second primary cancer sites, and defined alcohol consumption. Twenty potentially relevant full-text publications were identified (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29). We excluded one duplicate publication, as confirmed by the authors (10).…”

“…Ten studies (11)(12)(13)(14)(15)(16)(17)(18)(19)(20), reporting 493 cases among 6,385 participants, were included in highest versus lowest analyses of alcohol drinking and UADT second primary cancer. Figure 2 shows the summary RRs for highest versus lowest alcohol intake: 2.97 (95% CI, 1.96-4.50; P ¼ 0.0001), with evidence of moderate heterogeneity (P ¼ 0.158; I 2 ¼ 31.3%).…”

“…Two studies could be included in dose-response meta-analysis (12,14). One study could not be included because its number of cases was too small to calculate the slope (16). With a total of 157 cases among 3,614 participants, the summary RR for an increase in alcohol consumption of 10 grams per day was 1.09 (95% CI, 1.04-1.14; P ¼ 0.001), with no heterogeneity (P ¼ 0.351; I 2 ¼ 0.0%).…”

Prevalência de achados pulmonares em 55 pacientes com neoplasias esofagianas

“…Desse modo, existe o comprometimento direto de estruturas torácicas, principalmente pulmões (7) , traquéia e árvore brôn-quica , aorta, nervo laríngeo recorrente esquerdo, e também extratorácicas, como o cérebro e outros órgãos (11) . O carcinoma de células escamosas (com incidência maior que 85%) e o adenocarcinoma são os tipos mais freqüentes de carcinomas esofágicos (1,3,12,13) e estão relacionados com o consumo de álcool e tabaco, além de outras causas (14)(15)(16)(17) .…”