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Subjective factors affecting prognosis of 469 patients with esophageal squamous cell carcinoma: a retrospective cohort study of endoscopic screening

BACKGROUND: To date, no in-depth studies have focused on the impact of various clinical characteristics of esophageal squamous cell carcinoma (ESCC), including its association with subjective symptoms, on patient prognosis. We aimed to investigate the clinical factors that affect the prognosis of pa...

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Autores principales: Nakamura, Jun, Manabe, Noriaki, Yamatsuji, Tomoki, Fujiwara, Yoshinori, Murao, Takahisa, Ayaki, Maki, Fujita, Minoru, Shiotani, Akiko, Ueno, Tomio, Monobe, Yasumasa, Akiyama, Takashi, Haruma, Ken, Naomoto, Yoshio, Hata, Jiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9238142/
https://www.ncbi.nlm.nih.gov/pubmed/35764928
http://dx.doi.org/10.1186/s12876-022-02399-3
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author Nakamura, Jun
Manabe, Noriaki
Yamatsuji, Tomoki
Fujiwara, Yoshinori
Murao, Takahisa
Ayaki, Maki
Fujita, Minoru
Shiotani, Akiko
Ueno, Tomio
Monobe, Yasumasa
Akiyama, Takashi
Haruma, Ken
Naomoto, Yoshio
Hata, Jiro
author_facet Nakamura, Jun
Manabe, Noriaki
Yamatsuji, Tomoki
Fujiwara, Yoshinori
Murao, Takahisa
Ayaki, Maki
Fujita, Minoru
Shiotani, Akiko
Ueno, Tomio
Monobe, Yasumasa
Akiyama, Takashi
Haruma, Ken
Naomoto, Yoshio
Hata, Jiro
author_sort Nakamura, Jun
collection PubMed
description BACKGROUND: To date, no in-depth studies have focused on the impact of various clinical characteristics of esophageal squamous cell carcinoma (ESCC), including its association with subjective symptoms, on patient prognosis. We aimed to investigate the clinical factors that affect the prognosis of patients with ESCC and to clarify how subjective symptoms are related to prognosis. METHODS: We retrospectively evaluated the clinical records of 503 consecutive patients with ESCC from April 2011 to December 2019. Six established prognostic factors for ESCC (body mass index, alcohol drinking, cigarette smoking, sex, clinical stage, and age) and subjective symptoms were used to subgroup patients and analyze survival differences. Next, the patients were divided into two groups: a symptomatic group and an asymptomatic group. In the symptomatic group, differences in the incidence of subjective symptoms according to tumor size, tumor location, macroscopic tumor type, and clinical stage were examined. Finally, subjective symptoms were divided into swallowing-related symptoms and other symptoms, and their prognosis was compared. RESULTS: Multivariate Cox regression analysis identified sex [hazard ratio (HR) 1.778; 95% CI 1.004–3.149; p = 0.049], TNM classification (HR 6.591; 95% CI 3.438–12.63; p < 0.001), and subjective symptoms (HR 1.986; 95% CI 1.037–3.803; p = 0.0386) as independent risk factors for overall survival. In the symptomatic group, the mean time from symptom onset to diagnosis was 2.4 ± 4.3 months. The incidence of subjective symptoms differed by clinical stage, and the prognosis of patients with swallowing-related symptoms was significantly worse than that of patients with other symptoms. CONCLUSION: The results of this study suggest that screening by upper gastrointestinal endoscopy, independent of subjective symptoms (especially swallowing-related symptoms), may play an important role in the early detection and improvement of prognosis of ESCC, although further validation in a large prospective study is needed.
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spelling pubmed-92381422022-06-29 Subjective factors affecting prognosis of 469 patients with esophageal squamous cell carcinoma: a retrospective cohort study of endoscopic screening Nakamura, Jun Manabe, Noriaki Yamatsuji, Tomoki Fujiwara, Yoshinori Murao, Takahisa Ayaki, Maki Fujita, Minoru Shiotani, Akiko Ueno, Tomio Monobe, Yasumasa Akiyama, Takashi Haruma, Ken Naomoto, Yoshio Hata, Jiro BMC Gastroenterol Research Article BACKGROUND: To date, no in-depth studies have focused on the impact of various clinical characteristics of esophageal squamous cell carcinoma (ESCC), including its association with subjective symptoms, on patient prognosis. We aimed to investigate the clinical factors that affect the prognosis of patients with ESCC and to clarify how subjective symptoms are related to prognosis. METHODS: We retrospectively evaluated the clinical records of 503 consecutive patients with ESCC from April 2011 to December 2019. Six established prognostic factors for ESCC (body mass index, alcohol drinking, cigarette smoking, sex, clinical stage, and age) and subjective symptoms were used to subgroup patients and analyze survival differences. Next, the patients were divided into two groups: a symptomatic group and an asymptomatic group. In the symptomatic group, differences in the incidence of subjective symptoms according to tumor size, tumor location, macroscopic tumor type, and clinical stage were examined. Finally, subjective symptoms were divided into swallowing-related symptoms and other symptoms, and their prognosis was compared. RESULTS: Multivariate Cox regression analysis identified sex [hazard ratio (HR) 1.778; 95% CI 1.004–3.149; p = 0.049], TNM classification (HR 6.591; 95% CI 3.438–12.63; p < 0.001), and subjective symptoms (HR 1.986; 95% CI 1.037–3.803; p = 0.0386) as independent risk factors for overall survival. In the symptomatic group, the mean time from symptom onset to diagnosis was 2.4 ± 4.3 months. The incidence of subjective symptoms differed by clinical stage, and the prognosis of patients with swallowing-related symptoms was significantly worse than that of patients with other symptoms. CONCLUSION: The results of this study suggest that screening by upper gastrointestinal endoscopy, independent of subjective symptoms (especially swallowing-related symptoms), may play an important role in the early detection and improvement of prognosis of ESCC, although further validation in a large prospective study is needed. BioMed Central 2022-06-28 /pmc/articles/PMC9238142/ /pubmed/35764928 http://dx.doi.org/10.1186/s12876-022-02399-3 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Nakamura, Jun
Manabe, Noriaki
Yamatsuji, Tomoki
Fujiwara, Yoshinori
Murao, Takahisa
Ayaki, Maki
Fujita, Minoru
Shiotani, Akiko
Ueno, Tomio
Monobe, Yasumasa
Akiyama, Takashi
Haruma, Ken
Naomoto, Yoshio
Hata, Jiro
Subjective factors affecting prognosis of 469 patients with esophageal squamous cell carcinoma: a retrospective cohort study of endoscopic screening
title Subjective factors affecting prognosis of 469 patients with esophageal squamous cell carcinoma: a retrospective cohort study of endoscopic screening
title_full Subjective factors affecting prognosis of 469 patients with esophageal squamous cell carcinoma: a retrospective cohort study of endoscopic screening
title_fullStr Subjective factors affecting prognosis of 469 patients with esophageal squamous cell carcinoma: a retrospective cohort study of endoscopic screening
title_full_unstemmed Subjective factors affecting prognosis of 469 patients with esophageal squamous cell carcinoma: a retrospective cohort study of endoscopic screening
title_short Subjective factors affecting prognosis of 469 patients with esophageal squamous cell carcinoma: a retrospective cohort study of endoscopic screening
title_sort subjective factors affecting prognosis of 469 patients with esophageal squamous cell carcinoma: a retrospective cohort study of endoscopic screening
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9238142/
https://www.ncbi.nlm.nih.gov/pubmed/35764928
http://dx.doi.org/10.1186/s12876-022-02399-3
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