Risk of adenocarcinomas of the esophagus and gastric cardia in patients with gastroesophageal reflux diseases and after antireflux surgery

Ye, Weimin; Chow, Wong Ho; Lagergren, Jesper; Yin, Li; Nyrén, Olof

doi:10.1053/gast.2001.29569

Cited by 234 publications

(131 citation statements)

References 31 publications

Supporting

Mentioning

118

Contrasting

Unclassified

Order By: Relevance

“…An answer to this intriguing finding remains unclear. We speculate that because patients with high BMI are diagnosed with GERD more often than those with low BMI, [19][20][21][22][23] patients with high BMI are more likely to undergo endoscopic surveillance and this could result in the diagnosis of early EC. Lagergren et al 11 reported an odds ratio of 7.7 for EAC among patients with GERD symptoms compared with individuals without GERD symptoms.…”

Section: Discussionmentioning

confidence: 99%

The influence of high body mass index on the prognosis of patients with esophageal cancer after surgery as primary therapy

Hayashi¹,

Correa²,

Hofstetter³

et al. 2010

Cancer

View full text Add to dashboard Cite

BACKGROUND: High body mass index (BMI), a prevalent condition in the United States, is associated with esophageal adenocarcinoma (EAC). Its influence on a patient's outcome remains unclear. In the current study, the authors examined the impact of BMI on survival and complications in patients with esophageal cancer (EC) who underwent surgery as their primary therapy. METHODS: The authors retrospectively reviewed 301 consecutive EC patients who underwent surgery but received no adjunctive therapy. Patients were segregated into 2 subgroups based on their baseline BMI: normal/low (<25 kg/m 2 ) and high ( 25 kg/m 2 ). RESULTS: Seventy-six (25%) patients had a BMI <25 kg/m 2 and 225 (75%) patients had a BMI 25 kg/m 2 . In the high BMI group, there were more men (P < .001), fewer upper ECs (P ¼ .021), a lower baseline clinical stage (P ¼ .006), and frequent EAC (P < .001). Postoperative morbidity was similar in both groups, with the exception of gastrointestinal complications (P ¼ .016). The 5-year overall survival (OS) rates were 44% in the normal/low BMI group and 60% in the high BMI group (P ¼ .017). The 5-year disease-free survival (DFS) rates were 41% in the normal/low BMI group and 60% in the high BMI group (P ¼ .005). On multivariable analysis, age, weight loss, peripheral vascular disease (PVD), and both clinical and pathological stage of disease were found to be independent prognosticators for OS. Older age (hazard ratio [HR]

show abstract

Section: Discussionmentioning

confidence: 99%

The influence of high body mass index on the prognosis of patients with esophageal cancer after surgery as primary therapy

Hayashi¹,

Correa²,

Hofstetter³

et al. 2010

Cancer

View full text Add to dashboard Cite

show abstract

“…Gastroesophageal reflux appears to play an important role in the development of adenocarcinoma of the gastric cardia [25,26], and to have an etiology similar to esophageal adenocarcinoma [25]. Most non-cardia (distal) gastric adenocarcinomas arise as a long term complication of Helicobacter pylori infection of the stomach [25].…”

Section: Gastric Cancermentioning

confidence: 99%

Field defects in progression to gastrointestinal tract cancers

Bernstein

Payne

et al. 2008

Cancer Letters

View full text Add to dashboard Cite

A field of defective tissue may represent a pre-malignant stage in progression to many cancers. However, field defects are often overlooked in studies of cancer progression through assuming tissue at some distance from the cancer is normal. We indicate, however, the generality of field defects in gastrointestinal cancers, including cancers of the oropharynx, esophagus, stomach, bile duct, pancreas, small intestine and colon/rectum. Common features of these field defects are reduced apoptosis competence, aberrant proliferation and genomic instability. These features are often associated with high bile acid exposure and may explain the association of dietary-related factors with cancer progression.

show abstract

“…Use of tight belts 20 years ago 3 No exposure (never) 687 (86) 4 152 (84) Use of tight belts 20 years ago 6 No exposure (never) 687 (86) 152 (84) Observations with missing data on any covariate included in the models were excluded from the analyses.-2 Wald test of overall effect across all exposure strata.-3 Crude ORs controlled for age and sex by matching.- 4 Values in parentheses indicate percentages.- 5 Values in parentheses indicate 95% CIs.- 6 ORs adjusted for tobacco smoking, alcohol use, socioeconomic status and dietary intake of fruit and vegetables.- 7 ORs adjusted for reflux symptoms, BMI, tobacco smoking, alcohol use, socioeconomic status and dietary intake of fruit and vegetables.…”

Section: Resultsmentioning

confidence: 99%

Use of tight belts and risk of esophageal adenocarcinoma

Lagergren

Jansson

2006

Intl Journal of Cancer

Self Cite

View full text Add to dashboard Cite

It has recently been hypothesized that the general shift in use from suspenders to belts among men might be a factor that could promote reflux, particularly among overweight men, and thereby contribute to the alarmingly increasing incidence of esophageal and cardia adenocarcinoma. We addressed this hypothesis in a nationwide Swedish population-based case-control study, conducted in 1995-1997. Included were 189 patients with esophageal adenocarcinoma and 262 patients with cardia adenocarcinoma, who were compared with 167 patients with esophageal squamous cell carcinoma and 820 population-based control participants. Data were collected at structured face-to-face interviews with all study participants. Tumor classification was uniform and thorough. Odds ratios (OR) with 95% confidence intervals (CI), adjusted for potential confounders, were estimated in multivariable logistic regression models. Daily use of tight belts 20 years earlier did not entail an increased risk of adenocarcinoma of the esophagus (OR 1.1, 95% CI 0.7-1.8) or cardia (OR 0.8, 95% CI 0.5-1.3) compared to never use. Adjustment for reflux symptoms, body mass and other potentially relevant covariates did not influence the results. Similarly, in analyses restricted to overweight men, no associations were identified. No association with esophageal squamous cell carcinoma was found. In conclusion, this study provided no support for the hypothesis that use of tight belts is associated with an increased risk of developing esophageal or cardia adenocarcinoma. ' 2006 Wiley-Liss, Inc.Key words: tight garments; neoplasm; esophagus; gastric cardia Research aiming at identifying the reasons for the alarming increase in the incidence of adenocarcinoma of the esophagus and gastric cardia in industrialized countries during recent decades 1-4 is urgent and intense. Gastroesophageal reflux, 5-7 overweight 6,8,9 and male sex 3 have been established as the main known risk factors, but it remains uncertain why the incidence of these tumors is rising. 10,11 The rapidity of the increase suggests that environmental exposures are likely to be key factors. 10,11 Recently, an interesting hypothesis was proposed by La Vecchia et al., suggesting that the increasing secular trends of adenocarcinoma of the esophagus and gastric cardia, particularly among overweight men, is explained by the use of tight belts. 12 Such belts have a constraining influence on the abdomen, which in turn might promote reflux, and belts did not exist in the past when suspenders were in use. 12 This proposed mechanical exposure seems to fit well with all the above-presented prerequisites: increased and widespread use in industrialized populations, particularly among males, an environmental exposure and a possible combination with overweight to promote reflux, i.e., the established risk factors. As we had already included this hypothesis as part of the planning of a Swedish case-control study in the late 1990s, we investigated the relation between use of tight belts and risk of adenocarcinoma of the es...

show abstract

Risk of adenocarcinomas of the esophagus and gastric cardia in patients with gastroesophageal reflux diseases and after antireflux surgery

Cited by 234 publications

References 31 publications

The influence of high body mass index on the prognosis of patients with esophageal cancer after surgery as primary therapy

The influence of high body mass index on the prognosis of patients with esophageal cancer after surgery as primary therapy

Field defects in progression to gastrointestinal tract cancers

Use of tight belts and risk of esophageal adenocarcinoma

Contact Info

Product

Resources

About