Relationship of alcohol consumption patterns and hypopharyngeal carcinoma with second primary esophageal cancer
Objective To analyze the risk factors for the occurence of second primary esophageal cancer(SPEC)in patients with hypopharyngeal squamous cell carcinoma(HSCC),and to provide a clinical basis for SPEC monitoring.Method A total of 185 cases of HSCC treated in the Department of Head and Neck Surgery,Shandong Provincial ENT Hospital from January 1,2017 to December 31,2020 were included in this study.A retrospective analysis was performed on the electronic gastroscopy and gastroscopic biopsy results during hospitalization and the follow-up period.The patients were divided into two groups,namely the SPEC and SPEC-free groups,based on whether they had concomitant SPEC.The 5-year overall survival rates and differences in alcohol consumption patterns between the two groups were compared,and potential risk factors were explored.Statistical analysis was performed using Kaplan-Meier,hypothesis tests and univariate/multivariate unconditional logistic regression models.Results The 5-year overall survival rates of SPEC and SPEC-free groups were 39.8%and 50.2%,respectively(P=0.198).The multivariate unconditional logistic regression analysis showed that higher average daily alcohol intake(P=0.022,OR=1.111,95%CI:1.015-1.216),drinking on an empty stomach(P=0.019,OR=2.971,95%CI:1.196-7.378),and HSCC originating from the posterior wall of the hypopharynx(P=0.009,OR=3.786,95%CI:1.399-10.249)were risk factors for SPEC in HSCC patients with frequent alcohol con-sumption.The area under the curve of this logistic regression model predicting HSCC with concomitant SPEC was 0.765.Conclusion HSCC patients with frequent alcohol consumption are at higher risk of developing concomitant SPEC in cases of higher average daily alcohol intake,drinking on an empty stomach,and primary lesions located in the posterior wall of the hypopharynx.SPEC monitoring is necessary for patients with these characteristics.