Chemoprevention of Oesophageal Squamous-Cell Carcinoma and Adenocarcinoma: A Multicentre Retrospective Cohort Study.


Journal

Digestion
ISSN: 1421-9867
Titre abrégé: Digestion
Pays: Switzerland
ID NLM: 0150472

Informations de publication

Date de publication:
2022
Historique:
received: 11 08 2021
accepted: 09 11 2021
pubmed: 21 12 2021
medline: 10 5 2022
entrez: 20 12 2021
Statut: ppublish

Résumé

Oesophageal cancer comprises 2 different histological variants: oesophageal squamous-cell carcinoma (ESCC) and adenocarcinoma (EAC). While there are multiple therapeutic options for both types, patients with advanced or metastatic oesophageal cancer still suffer from poor prognosis. The study aimed to examine the association between the risk of oesophageal cancer and medications and to estimate the chemopreventive effects of commonly used drugs. A multicentre retrospective cohort study was conducted using data from 9 hospital databases of hospitalized patients between 2014 and 2019. The primary outcomes were ESCC and EAC. The association of oesophageal cancer with drug use and clinical factors was evaluated. Odds ratios (ORs) were adjusted for age, sex, Charlson comorbidity index scores, and smoking with/without gastro-oesophageal reflux disease. The use of proton pump inhibitors (PPIs) (adjusted OR [aOR] 0.48, p < 0.0001), aspirin (aOR 0.32, p < 0.0001), cyclooxygenase-2 inhibitor (COX2I) (aOR 0.70, p = 0.0005), steroid (aOR 0.19, p < 0.0001), statin (aOR 0.43, p < 0.0001), and metformin (aOR 0.42, p < 0.0001) was associated with a lower risk of ESCC than that in non-use. The use of aspirin (aOR 0.33, p = 0.0006) and steroids (aOR 0.54, p = 0.022) was associated with a lower risk of EAC than that in non-use. COX2Is, statins, metformin, and PPIs could help in prevention of ESCC, and aspirin and steroids may be chemopreventive for both types of oesophageal cancer.

Sections du résumé

BACKGROUND BACKGROUND
Oesophageal cancer comprises 2 different histological variants: oesophageal squamous-cell carcinoma (ESCC) and adenocarcinoma (EAC). While there are multiple therapeutic options for both types, patients with advanced or metastatic oesophageal cancer still suffer from poor prognosis.
AIMS OBJECTIVE
The study aimed to examine the association between the risk of oesophageal cancer and medications and to estimate the chemopreventive effects of commonly used drugs.
METHODS METHODS
A multicentre retrospective cohort study was conducted using data from 9 hospital databases of hospitalized patients between 2014 and 2019. The primary outcomes were ESCC and EAC. The association of oesophageal cancer with drug use and clinical factors was evaluated. Odds ratios (ORs) were adjusted for age, sex, Charlson comorbidity index scores, and smoking with/without gastro-oesophageal reflux disease.
RESULTS RESULTS
The use of proton pump inhibitors (PPIs) (adjusted OR [aOR] 0.48, p < 0.0001), aspirin (aOR 0.32, p < 0.0001), cyclooxygenase-2 inhibitor (COX2I) (aOR 0.70, p = 0.0005), steroid (aOR 0.19, p < 0.0001), statin (aOR 0.43, p < 0.0001), and metformin (aOR 0.42, p < 0.0001) was associated with a lower risk of ESCC than that in non-use. The use of aspirin (aOR 0.33, p = 0.0006) and steroids (aOR 0.54, p = 0.022) was associated with a lower risk of EAC than that in non-use.
CONCLUSION CONCLUSIONS
COX2Is, statins, metformin, and PPIs could help in prevention of ESCC, and aspirin and steroids may be chemopreventive for both types of oesophageal cancer.

Identifiants

pubmed: 34929693
pii: 000520924
doi: 10.1159/000520924
pmc: PMC9153329
doi:

Substances chimiques

Hydroxymethylglutaryl-CoA Reductase Inhibitors 0
Proton Pump Inhibitors 0
Metformin 9100L32L2N
Aspirin R16CO5Y76E

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

192-204

Informations de copyright

© 2021 The Author(s). Published by S. Karger AG, Basel.

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Auteurs

Junya Arai (J)

Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan, ayayadejunya@yahoo.co.jp.

Ryota Niikura (R)

Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Gastroenterological Endoscopy, Tokyo Medical University, Tokyo, Japan.

Yoku Hayakawa (Y)

Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

Takuya Kawahara (T)

Clinical Research Promotion Center, The University of Tokyo Hospital, Tokyo, Japan.

Tetsuro Honda (T)

Department of Gastroenterology, Nagasaki Harbor Medical Center, Nagasaki, Japan.

Kenkei Hasatani (K)

Department of Gastroenterology, Fukui Prefectural Hospital, Fukui, Japan.

Naohiro Yoshida (N)

Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa-shi, Japan.

Tsutomu Nishida (T)

Department of Gastroenterology, Toyonaka Municipal Hospital, Osaka, Japan.

Tetsuya Sumiyoshi (T)

Department of Gastroenterology, Tonan Hospital, Sapporo-shi, Japan.

Shu Kiyotoki (S)

Department of Gastroenterology, Shuto General Hospital, Yamaguchi, Japan.

Takashi Ikeya (T)

Department of Gastroenterology, St. Luke's International Hospital, Tokyo, Japan.

Masahiro Arai (M)

Department of Gastroenterology, Nerima Hikarigaoka Hospital, Tokyo, Japan.

Nobumi Suzuki (N)

Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

Yosuke Tsuji (Y)

Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

Atsuo Yamada (A)

Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

Takashi Kawai (T)

Gastroenterological Endoscopy, Tokyo Medical University, Tokyo, Japan.

Kazuhiko Koike (K)

Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

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Classifications MeSH