Facial flushing after alcohol intake as a predictor for a high risk of synchronous or metachronous cancer of the upper gastrointestinal tract

Harada, Hiroyuki; Shinohara, Shogo; Takebayashi, Shinji; Kikuchi, Masahiro; Fujiwara, Kenshu; Michida, Tetsuhiko; Yamamoto, Ryosuke; Hayashi, Kazuki; Saida, Kooichi; Naito, Yasushi

doi:10.1093/jjco/hyx150

Cited by 11 publications

(16 citation statements)

References 21 publications

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“…Alcohol [12, 16, 22–25], cigarette smoke [12, 16, 24], and alcohol metabolizing enzyme deficiencies such as aldehyde dehydrogenase-2 (ALDH2) [12, 26] are the main risk factors for HNC and esophageal cancer. Enzyme deficiencies as well as duration and density of exposure to alcohol and cigarette smoke may determine the risk of these cancers [12, 24].…”

Section: Discussionmentioning

confidence: 99%

Impact of age at diagnosis of head and neck cancer on incidence of metachronous cancer

et al. 2019

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BackgroundMetachronous cancer in patients with head and neck cancer (HNC) is common and is associated with a poor prognosis. We aimed to evaluate the incidence of metachronous cancer at different sites according to age at diagnosis of index HNC.MethodsWe collected data on 2011 patients with oral cancer, oropharynx cancer, hypopharyngeal cancer, and laryngeal cancer as index cancers using the Osaka International Cancer Institute Cancer Registry database between 2005 and 2016. Among these, we analyzed 1953 patients after excluding 5 patients who were not followed-up and 53 patients with simultaneous multiple index cancers. We evaluated the cumulative incidence of metachronous cancer in the esophagus, lung, and other sites according to age at diagnosis of the index HNC using the Kaplan–Meier method. Multivariate logistic regression analysis was performed to identify factors that influenced the incidence of metachronous cancers following HNC.ResultsThe cumulative incidence of metachronous esophageal cancer in young patients (< 65 years) was significantly higher than that in old patients (≥ 65 years) (12.1% vs 8.5% at 5 years, and 16.5% vs 11.2% at 10 years; p = 0.015). On the other hand, the cumulative incidence of the other cancers in young patients was significantly lower than that in old patients (7.8% vs 12.2% at 5 years, and 13.9% vs 15.3% at 10 years; p = 0.017). The cumulative incidence of lung cancer was not significance according to age at diagnosis of the index HNC. In the multivariate analysis, histological type (squamous cell carcinoma) and lesion location (hypopharynx and larynx) were independently associated with metachronous cancers. Moreover, age at diagnosis of the index HNC (< 65 years), histological type (squamous cell carcinoma) and lesion location (hypopharynx) were significant predictors of metachronous esophageal cancer incidence and lesion location (hypopharynx) was a significant predictor of metachronous lung cancer incidence.ConclusionRisk stratification of metachronous cancers with age and other predictors may help to properly manage patients with HNC.Trial registrationThe present study is a non-intervention trial.

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Section: Discussionmentioning

confidence: 99%

Impact of age at diagnosis of head and neck cancer on incidence of metachronous cancer

et al. 2019

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“…However, fewer studies have analyzed the risk factors for metachronous ESCNs. In a retrospective study, Harada et al found that only facial flush after drinking, but not smoking or drinking, was a risk factor for synchronous and metachronous gastrointestinal tract cancers, but the metachronous cancers included oral, oropharyngeal, hypopharyngeal, esophageal, and gastric cancers [14]. Fukuhara et al retrospectively analyzed 135 patients with primary HNSCC and found that multiple LVLs were significantly associated with the development of metachronous ESCC [10].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Surveillance for Metachronous Esophageal Squamous Cell Neoplasms among Head and Neck Cancer Patients

Chen

Wang

Chuang

et al. 2020

Cancers

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Esophageal squamous cell neoplasms (ESCNs) are the most common second primary neoplasm in patients with head and neck squamous cell carcinoma (HNSCC), and few studies have focused on metachronous ESCNs. We aimed to evaluate the incidence of and risk factors for metachronous ESCNs and to provide a reasonable endoscopic follow-up plan for HNSCC patients. We extended our prospective cohort since October 2008 by recruiting incident HNSCC patients. All enrolled patients were interviewed to collect information on substance use (smoking, alcohol, and betel nut) and esophagogastroduodenoscopy (EGD) with Lugol chromoendoscopy results for synchronous ESCNs soon after HNSCC diagnosis. Endoscopic screenings for metachronous ESCNs were performed 6 to 12 months after the previous examinations. A total of 1042 incident HNSCC patients were enrolled, but only 175 patients met all the criteria and were analyzed. A total of 20 patients had metachronous ESCNs (20/175, 11.4%). Only the initial Lugol-voiding lesion (LVL) classification significantly predicted the development of metachronous ESCNs. Patients with an LVL classification of C/D had a higher risk of developing metachronous ESCNs than those with an LVL classification of A/B (adjusted odds ratio: 5.03, 95% confidence interval: 1.52–16.67). The mean interval for developing metachronous ESCNs was 33 months, but the shortest interval for developing metachronous esophageal squamous cell carcinoma was 12 months. Lugol chromoendoscopy screening among incident HNSCC patients predicts the risk of developing metachronous ESCNs. A closer follow-up with an endoscopy every 6 months is recommended for those with LVL classifications of C and D.

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“…Hence a typical pint of beer at 4.5% ABV contains 2.5 units, a standard glass of wine (175ml) at 13.5%ABVis 2.3 units and a measure of whisky (25ml) at 40%ABV is 1 unit). In the Netherlands, it is 9.9 g. In France and Ireland, 10 g, in the USA it is 14 g and in Japan 22 g 4 . When comparing data between countries because of the variability in what constitutes a unit of alcohol, Tramacere et al converted the alcohol consumed into grams of alcohol using the following formula: 0.8g/ml=28.35 g/ounce= 12.5 g/ drink 5 .…”

Section: Introductionmentioning

confidence: 93%

Alcohol and mouth cancer

Ogden

2018

Br Dent J

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British Dental JournalIn brief It is not alcohol but rather the first metabolite of alcohol, acetaldehyde, which is the most important carcinogen. Patients should be made aware of their alcohol unit intake (eg consider keeping an alcohol diary or using an App). Alcohol containing mouthwashes are essentially safe (being associated with a slightly increased risk of mouth cancer if used more than twice a day and for greater than 35 years). AbstractThere is now considered to be no safe limit for alcohol intake . Studies have shown that risk of mouth cancer increases with greater alcohol intake (in particular when associated with the use of tobacco). This paper reviews the role for alcohol in the aetiology of mouth cancer both in terms of how it may give rise to cancerous change and the relative risk it carries (arising from various systematic and meta-analyses reported over the last decade). Whilst obtaining a reliable alcohol history can be problematic (with under reporting frequently suspected) greater awareness of the role of alcohol in both local and systemic disease (in particular that of cancer in an ever increasing number of sites) may serve as a motivator for behaviour change within our patients.To that end patients should be aware of the alcohol content in the drinks they consume and consider recording their alcohol intake over a defined period (eg use of a diary or App over a 2 to 4 week period)

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Facial flushing after alcohol intake as a predictor for a high risk of synchronous or metachronous cancer of the upper gastrointestinal tract

Abstract: A simple interview on history of facial flushing after alcohol intake can be useful for identifying patients at high risk for synchronous or metachronous cancers of the UGI tract.

Cited by 11 publications

References 21 publications

Impact of age at diagnosis of head and neck cancer on incidence of metachronous cancer

Impact of age at diagnosis of head and neck cancer on incidence of metachronous cancer

Endoscopic Surveillance for Metachronous Esophageal Squamous Cell Neoplasms among Head and Neck Cancer Patients

Alcohol and mouth cancer

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