title: Alcohol abstinence and risk assessment for second esophageal cancer in Japanese men after mucosectomy for early esophageal cancer.
abstract: BACKGROUND
  Alcohol consumption combined with inactive aldehyde dehydrogenase-2 (ALDH2) and the presence of multiple esophageal Lugol-voiding lesions (LVLs; dysplasia) are strong predictors for multiple development of esophageal squamous cell carcinoma (ESCC) in East Asians. We invented a health risk appraisal (HRA) model for predicting the risk of ESCC based on drinking, smoking, dietary habits, and alcohol flushing, i.e., past or present facial flushing after drinking a glass of beer, a surrogate marker for inactive ALDH2.
  
  
  METHODS
  Prospective follow-up examinations (median follow-up time, 50.3 months) were performed in 278 Japanese men after endoscopic mucosectomy for early ESCC (UMIN Clinical Trials Registry ID: UMIN000001676).
  
  
  RESULTS
  Sixty-four subjects developed metachronous ESCC. A receiver operating characteristic curve showed that HRA scores ≥12 best predicted the development of metachronous ESCC. The ESCC detection rate per 100 person-years was 9.8 in the high-HRA-score group (n = 104) and 4.5 in the low-HRA-score group (n = 174), and the risk of development of metachronous ESCC was higher in the high-HRA-score group than in the low-HRA-score group (adjusted hazard ratio: 2.00 [95% CI: 1.12-3.30]). Multiple LVLs was a very strong predictor of the development of metachronous SCC, but high HRA scores predicted it independently. The cumulative incidences of metachronous ESCC decreased after drinking cessation in the high-HRA-score drinker group (adjusted hazard ratio: 0.37 [0.14-0.97]).
  
  
  CONCLUSIONS
  Both the HRA model that included alcohol flushing and the multiple LVL grade predicted the development of metachronous ESCC in Japanese men after endoscopic mucosectomy for ESCC. Drinking cessation in the high-HRA-score drinker group reduced the rate of metachronous ESCC.
authors.affiliation: National Hospital Organization Kurihama Medical and Addiction Center, Kanagawa, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Yokoyama
authors.affiliation: Department of Gastroenterology, Kitasato University School of Medicine, Kanagawa, Japan.
authors.forename: Chikatoshi
authors.initials: C
authors.lastname: Katada
authors.affiliation: Department of Health Promotion, National Institute of Public Health, Saitama, Japan.
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Yokoyama
authors.affiliation: Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Chiba, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Yano
authors.affiliation: Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Chiba, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kaneko
authors.affiliation: Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Oda
authors.affiliation: Department of Gastroenterology, Hokkaido University Graduate School of Medicine, Kokkaido, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Shimizu
authors.affiliation: Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Doyama
authors.affiliation: Division of Gastroenterology, Tohoku University Graduate School of Medicine, Miyagi, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Koike
authors.affiliation: Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Takizawa
authors.affiliation: Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan.
authors.forename: Motohiro
authors.initials: M
authors.lastname: Hirao
authors.affiliation: Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Okada
authors.affiliation: Department of Gastroenterology, Kanagawa Cancer Center, Kanagawa, Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Yoshii
authors.affiliation: Division of Gastroenterology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Konishi
authors.affiliation: Department of Gastroenterology, Kumamoto Regional Medical Center, Kumamoto, Japan.
authors.forename: Takenori
authors.initials: T
authors.lastname: Yamanouchi
authors.affiliation: Department of Clinical Oncology, St. Marianna University School of Medicine, Kanagawa, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Tsuda
authors.affiliation: Endoscopy Center, Kawasaki Municipal Ida Hospital, Kanagawa, Japan.
authors.forename: Tai
authors.initials: T
authors.lastname: Omori
authors.affiliation: Department of Diagnostic Imaging, Tochigi Cancer Center, Tochigi, Japan.
authors.forename: Nozomu
authors.initials: N
authors.lastname: Kobayashi
authors.affiliation: Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Haruhisa
authors.initials: H
authors.lastname: Suzuki
authors.affiliation: Research and Development Center for New Frontiers, Kitasato University School of Medicine, Kanagawa, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tanabe
authors.affiliation: Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Chiba, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Hori
authors.affiliation: Department of Gastroenterology, Kanagawa Cancer Center, Kanagawa, Japan.
authors.forename: Norisuke
authors.initials: N
authors.lastname: Nakayama
authors.affiliation: Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kawakubo
authors.affiliation: Department of Molecular-Targeting Cancer Prevention, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishikawa
authors.affiliation: Department of Therapeutic Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Muto
mesh_terms: D000328:Adult; D000368:Aged; D064829:Alcohol Abstinence; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011446:Prospective Studies; D018570:Risk Assessment