Gastro Hep Advances (Jan 2022)
Field Effect of Alcohol, Cigarette Smoking, and Their Cessation on the Development of Multiple Dysplastic Lesions and Squamous Cell Carcinoma: A Long-term Multicenter Cohort Study
- Manabu Muto,
- Chikatoshi Katada,
- Tetsuji Yokoyama,
- Tomonori Yano,
- Ichiro Oda,
- Yasumasa Ezoe,
- Satoshi Tanabe,
- Yuichi Shimizu,
- Hisashi Doyama,
- Tomoyuki Koike,
- Kohei Takizawa,
- Motohiro Hirao,
- Hiroyuki Okada,
- Takashi Ogata,
- Atsushi Katagiri,
- Takenori Yamanouchi,
- Yasumasa Matsuo,
- Hirofumi Kawakubo,
- Tai Omori,
- Nozomu Kobayashi,
- Tadakazu Shimoda,
- Atsushi Ochiai,
- Hideki Ishikawa,
- Kiichiro Baba,
- Yusuke Amanuna,
- Akira Yokoyama,
- Shinya Ohashi,
- Akira Yokoyama,
- Kazuhiro Kaneko,
- Shuko Morita,
- Makiko Funakoshi,
- Takahiro Horimatsu,
- Mari Takahashi,
- Kazuhiro Kaneko,
- Haruhisa Suzuki,
- Satoshi Abiko,
- Kenichi Takemura,
- Hiroyoshi Nakanishi,
- Masahiro Saito,
- Nobuyuki Ara,
- Naomi Kakushima,
- Masaki Tanaka,
- Keisuke Hori,
- Takashi Tsuda
Affiliations
- Manabu Muto
- Department of Therapeutic Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan; Correspondence: Address correspondence to: Manabu Muto, MD, PhD, Department of Therapeutic Oncology, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Syogoin, Sakyo-ku, Kyoto 606-8507, Japan.
- Chikatoshi Katada
- Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Japan
- Tetsuji Yokoyama
- Department of Health Promotion, National Institute of Public Health, Wako, Japan
- Tomonori Yano
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan
- Ichiro Oda
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
- Yasumasa Ezoe
- Department of Therapeutic Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Satoshi Tanabe
- Research and Development Center for New Frontiers, Kitasato University School of Medicine, Sagamihara, Japan
- Yuichi Shimizu
- Division of Endoscopy, Hokkaido University Hospital, Sapporo, Japan
- Hisashi Doyama
- Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
- Tomoyuki Koike
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
- Kohei Takizawa
- Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
- Motohiro Hirao
- Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan
- Hiroyuki Okada
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
- Takashi Ogata
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan
- Atsushi Katagiri
- Division of Gastroenterology, Department of Medicine, Showa University Hospital, Tokyo, Japan
- Takenori Yamanouchi
- Department of Gastroenterology, Kumamoto Regional Medical Center, Kumamoto, Japan
- Yasumasa Matsuo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
- Hirofumi Kawakubo
- Department of Surgery, Kawasaki Municipal Kawasaki Hospital, Kawasaki, Japan
- Tai Omori
- Department of Surgery, Kawasaki Municipal Kawasaki Hospital, Kawasaki, Japan
- Nozomu Kobayashi
- Department of Gastroenterology, Tochigi Cancer Center, Utsunomiya, Japan
- Tadakazu Shimoda
- Department of Diagnostic Pathology, Shizuoka Cancer Center, Shizuoka, Japan
- Atsushi Ochiai
- Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Japan
- Hideki Ishikawa
- Department of Molecular-Targeting Cancer Prevention, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Kiichiro Baba
- Department of Therapeutic Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Yusuke Amanuna
- Department of Therapeutic Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Akira Yokoyama
- Department of Therapeutic Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Shinya Ohashi
- Department of Therapeutic Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Akira Yokoyama
- Clinical Research Unit, National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Japan
- Kazuhiro Kaneko
- Shuko Morita
- Makiko Funakoshi
- Takahiro Horimatsu
- Mari Takahashi
- Kazuhiro Kaneko
- Haruhisa Suzuki
- Satoshi Abiko
- Kenichi Takemura
- Hiroyoshi Nakanishi
- Masahiro Saito
- Nobuyuki Ara
- Naomi Kakushima
- Masaki Tanaka
- Keisuke Hori
- Takashi Tsuda
- Journal volume & issue
-
Vol. 1,
no. 2
pp. 265 – 276
Abstract
Background and Aims: Multiple developments of squamous dysplasia and squamous cell carcinoma (SCC) in the upper aerodigestive tract have been explained by field cancerization phenomenon and were associated with alcohol and cigarette use. Second primary SCC development after curative treatment impairs patients’ quality of life and survival; however, how these consumption and cessation affect field cancerization is still unknown. Methods: This is a multicenter cohort study including 331 patients with superficial esophageal SCC (ESCC) treated endoscopically and pooled data from 1022 healthy subjects for comparison. Physiological condition in the background esophageal mucosa was classified into 3 groups based on the number of Lugol-voiding lesions (LVLs) per endoscopic view: grade A, 0; grade B, 1–9; or grade C, ≥10 LVLs. Lifestyle surveys were conducted using a self-administered questionnaire. Patients were counseled on the need for alcohol and smoking cessation by physicians and were endoscopically surveyed every 6 months. Results: LVL grades were positively associated with alcohol drinking intensity, flushing reactions, smoking, and high-temperature food and were negatively associated with eating green and yellow vegetables and fruit. Second primary ESCC and head/neck SCC were significantly more prevalent in the grade C LVL (cumulative 5-y incidences 47.1%, 95% confidence interval [CI] = 38.0–57.2 and 13.3%, 95% CI = 8.1–21.5, respectively). Alcohol and smoking cessation significantly reduced the development of second primary ESCC (adjusted hazard ratios 0.47, 95% = CI 0.26–0.85 and 0.49, 95% CI = 0.26–0.91, respectively). Conclusion: Alcohol drinking, smoking, flushing reaction, and high-temperature food were closely associated with field cancerization, and cessation of alcohol and smoking significantly reduced the risk of development of second primary cancer. UMIN Clinical Trials Registry ID:UMIN000001676.
