Research

10 pages, 885 KiB

Open AccessArticle

Association of Albumin-Corrected Serum Calcium Levels with Colorectal Cancer Survival Outcomes

by Marina Nogueira Silveira, Lara Pozzuto, Maria Carolina Santos Mendes, Lorena Pires da Cunha, Felipe Osório Costa, Lígia Traldi Macedo, Sandra Regina Brambilla and José Barreto Campello Carvalheira

J. Clin. Med. 2022, 11(10), 2928; https://doi.org/10.3390/jcm11102928 - 22 May 2022

Cited by 1 | Viewed by 1486

Abstract

In epidemiological studies, higher calcium intake has been associated with decreased colorectal cancer (CRC) incidence. However, whether circulating calcium concentrations are associated with CRC prognosis is largely unknown. In this retrospective cohort analysis, we identified 498 patients diagnosed with stage I–IV CRC between [...] Read more.

In epidemiological studies, higher calcium intake has been associated with decreased colorectal cancer (CRC) incidence. However, whether circulating calcium concentrations are associated with CRC prognosis is largely unknown. In this retrospective cohort analysis, we identified 498 patients diagnosed with stage I–IV CRC between the years of 2000 and 2018 in whom calcium and albumin level measurements within 3 months of diagnosis had been taken. We used the Kaplan–Meier method for survival analysis. We used multivariate Cox proportional hazards regression to identify associations between corrected calcium levels and CRC survival outcomes. Corrected calcium levels in the highest tertile were associated with significantly lower progression-free survival rates (hazard ratio (HR) 1.85; 95% confidence interval (CI) 1.28–2.69; p = 0.001) and overall survival (HR 1.86; 95% CI 1.26–2.74, p = 0.002) in patients with stage IV or recurrent CRC, and significantly lower disease-free survival rates (HR 1.44; 95% confidence interval (CI) 1.02–2.03; p = 0.040) and overall survival rates (HR 1.72; 95% CI 1.18–2.50; p = 0.004) in patients with stage I–III disease. In conclusion, higher corrected calcium levels after the diagnosis of CRC were significantly associated with decreased survival rates. Prospective trials are necessary to confirm this association. Full article

(This article belongs to the Special Issue Gastrointestinal Malignancies: Screening, Diagnosis, and Treatment)

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11 pages, 466 KiB

Open AccessArticle

The Significance of Selected C-C Motif Chemokine Ligands in Colorectal Cancer Patients

by Monika Zajkowska, Maciej Dulewicz, Agnieszka Kulczyńska-Przybik, Kamil Safiejko, Marcin Juchimiuk, Marzena Konopko, Leszek Kozłowski and Barbara Mroczko

J. Clin. Med. 2022, 11(7), 1794; https://doi.org/10.3390/jcm11071794 - 24 Mar 2022

Cited by 5 | Viewed by 1658

Abstract

Colorectal cancer (CRC) is one of the most frequently diagnosed neoplasms. Despite the advances in diagnostic tools and treatments, the number of CRC cases is increasing. Therefore, it is vital to search for new parameters that could be useful in its diagnosis. Thus, [...] Read more.

Colorectal cancer (CRC) is one of the most frequently diagnosed neoplasms. Despite the advances in diagnostic tools and treatments, the number of CRC cases is increasing. Therefore, it is vital to search for new parameters that could be useful in its diagnosis. Thus, we wanted to assess the usefulness of selected CC chemokines (CCL2, CCL4, and CCL15) in CRC. The study included 115 subjects (75 CRC patients and 40 healthy volunteers). The serum concentrations of all parameters were measured using a multiplexing method (Luminex). The CRP levels were determined by immunoturbidimetry, and the classical tumor markers (CEA and CA 19-9) were measured using CMIA (chemiluminescent microparticle immunoassay). The concentrations of all parameters were higher in the CRC group when compared to the healthy controls. The diagnostic sensitivity, specificity, positive and negative predictive value, and area under the ROC curve (AUC) of all estimated CC chemokines were higher than those of CA 19-9. Interestingly, the obtained results also suggest CCL2’s significance in the determination of local metastases and CCL4’s significance in the determination of distant metastases. However, further studies concerning the role of selected CC chemokines in the course of colorectal cancer are necessary to confirm and to fully clarify their diagnostic utility and their clinical application as markers of CRC development. Full article

(This article belongs to the Special Issue Gastrointestinal Malignancies: Screening, Diagnosis, and Treatment)

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13 pages, 767 KiB

Open AccessArticle

Cigarette Smoking Associated with Colorectal Cancer Survival: A Nationwide, Population-Based Cohort Study

by Yu-Min Huang, Po-Li Wei, Chung-Han Ho and Chih-Ching Yeh

J. Clin. Med. 2022, 11(4), 913; https://doi.org/10.3390/jcm11040913 - 09 Feb 2022

Cited by 6 | Viewed by 2187

Abstract

We investigate whether cigarette smoking is associated with survival in patients with colorectal cancer (CRC) through a nationwide population-based cohort study in Taiwan. The Taiwan Cancer Registry and National Health Insurance Research Database were used to identify data from patients with CRC from [...] Read more.

We investigate whether cigarette smoking is associated with survival in patients with colorectal cancer (CRC) through a nationwide population-based cohort study in Taiwan. The Taiwan Cancer Registry and National Health Insurance Research Database were used to identify data from patients with CRC from 2011 to 2017. Tobacco use was evaluated based on the smoking status, intensity, and duration before cancer diagnosis. A total of 18,816 patients was included. A Kaplan–Meier survival analysis indicated smoking to be significantly associated with the CRC mortality risk (log-rank p = 0.0001). A multivariable Cox model indicated that smoking patients had a 1.11-fold higher mortality risk (HR = 1.11, 95% CI = 1.05–1.19) than nonsmoking patients did. This increased risk was also present in patients with CRC who smoked 11–20 cigarettes per day (HR = 1.16; 95% CI = 1.07–1.26) or smoked for >30 years (HR = 1.14; 95% CI = 1.04–1.25). Stratified analyses of sex and cancer subsites indicated that the effects of smoking were higher in male patients and in those with colon cancer. Our results indicate that cigarette smoking is significantly associated with poor survival in patients with CRC. An integrated smoking cessation campaign is warranted to prevent CRC mortality. Full article

(This article belongs to the Special Issue Gastrointestinal Malignancies: Screening, Diagnosis, and Treatment)

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9 pages, 3155 KiB

Open AccessArticle

Clinical Differences in c-Myc Expression in Early-Stage Gastric Neoplasia: A Retrospective Study Based on the WHO Classification

by Noriyuki Arakawa, Atsushi Irisawa, Kazuyuki Ishida, Takuya Tsunoda, Yoshiko Yamaguchi, Goro Shibukawa, Makoto Eizuka, Shunzo Tokioka and Hiroto Wakabayashi

J. Clin. Med. 2022, 11(3), 544; https://doi.org/10.3390/jcm11030544 - 21 Jan 2022

Viewed by 1338

Abstract

c-Myc is an oncogene that is dysregulated in various cancers. Early gastric neoplasia with c-Myc expression has been reported as a more malignant lesion. This study clarifies the differences in c-Myc expression in early gastric neoplasia based on the WHO classification. Samples from [...] Read more.

c-Myc is an oncogene that is dysregulated in various cancers. Early gastric neoplasia with c-Myc expression has been reported as a more malignant lesion. This study clarifies the differences in c-Myc expression in early gastric neoplasia based on the WHO classification. Samples from 100 patients with differentiated-type early gastric neoplasia, who underwent endoscopic submucosal dissection between March 2020 and January 2021, were stained for c-Myc. One hundred lesions were classified as low-grade dysplasia, high-grade dysplasia, or intramucosal adenocarcinoma. The staining intensity and extent were scored. A hierarchical cluster analysis for a clinicopathological analysis among the groups, the chi-square test, Bonferroni correction, and residual analysis were performed. Subgroup one and two consisted of 39 patients; while subgroup three consisted of 22. Significant differences among various characteristics were observed between these subgroups. The frequency of low-grade dysplasia was significantly higher, while that of high-grade dysplasia was significantly lower in subgroup three. The frequency of intramucosal adenocarcinoma was significantly higher in subgroup one. The c-Myc positivity rate was significantly higher in subgroup one compared with that in subgroup three. c-Myc expression distinctly differed in early gastric neoplasia. c-Myc-negative low-grade dysplasia may be separately categorized from c-Myc-positive low-grade dysplasia, high-grade dysplasia, and intramucosal adenocarcinoma. Full article

(This article belongs to the Special Issue Gastrointestinal Malignancies: Screening, Diagnosis, and Treatment)

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10 pages, 1956 KiB

Open AccessArticle

Association of Regular Endoscopic Screening with Interval Gastric Cancer Incidence in the National Cancer Screening Program

by Choong-Kyun Noh, Eunyoung Lee, Gil Ho Lee, Sun Gyo Lim, Bumhee Park, Sung Jae Shin, Jae Youn Cheong and Kee Myung Lee

J. Clin. Med. 2022, 11(1), 230; https://doi.org/10.3390/jcm11010230 - 31 Dec 2021

Cited by 9 | Viewed by 1641

Abstract

Although regular endoscopic screening may help in early detection of gastric cancer, interval cancer remains a problem in the screening program. This study evaluated the association between regular endoscopic screening and interval cancer detection in the Korean National Cancer Screening Program (KNCSP). We [...] Read more.

Although regular endoscopic screening may help in early detection of gastric cancer, interval cancer remains a problem in the screening program. This study evaluated the association between regular endoscopic screening and interval cancer detection in the Korean National Cancer Screening Program (KNCSP). We defined three groups (regularly, irregularly, and not screened) according to the screening interval, and the trends in the interval cancer rate (ICR) between the groups were tested using the Cochran–Armitage test. The influence of regular endoscopic screening on the risk of interval cancer was evaluated using multivariable logistic regression. Among the 11,642,410 participants who underwent endoscopy, the overall ICR was 0.36 per 1000 negative screenings. The ICR of the not screened group (0.41) was the highest among the three groups and the risk of interval cancer in this group was 1.68 times higher (p < 0.001) than that in the regularly screened group. Women in their 40s who had regular screening with no history of intestinal metaplasia and gastric polyps would have the lowest probability of having interval cancer (0.005%). Regular participation in endoscopic screening programs for reducing the risk of interval cancer may help to improve the quality of screening programs. Full article

(This article belongs to the Special Issue Gastrointestinal Malignancies: Screening, Diagnosis, and Treatment)

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12 pages, 594 KiB

Open AccessArticle

Gastric Xanthelasma, Microsatellite Instability and Methylation of Tumor Suppressor Genes in the Gastric Mucosa: Correlation and Comparison as a Predictive Marker for the Development of Synchronous/Metachronous Gastric Cancer

by Masashi Fukushima, Hirokazu Fukui, Jiro Watari, Chiyomi Ito, Ken Hara, Hirotsugu Eda, Toshihiko Tomita, Tadayuki Oshima and Hiroto Miwa

J. Clin. Med. 2022, 11(1), 9; https://doi.org/10.3390/jcm11010009 - 21 Dec 2021

Cited by 3 | Viewed by 2553

Abstract

A predictive marker for the development of synchronous/metachronous gastric cancer (GC) would be highly desirable in order to establish an effective strategy for endoscopic surveillance. Herein, we examine the significance of gastric xanthelasma (GX) and molecular abnormalities for the prediction of synchronous/metachronous GC. [...] Read more.

A predictive marker for the development of synchronous/metachronous gastric cancer (GC) would be highly desirable in order to establish an effective strategy for endoscopic surveillance. Herein, we examine the significance of gastric xanthelasma (GX) and molecular abnormalities for the prediction of synchronous/metachronous GC. Patients (n = 115) were followed up (range, 12–122; median, 55 months) in whom the presence of GX and molecular alterations, including microsatellite instability (MSI) and methylation of human mutL homolog 1 (hMLH1), cyclin-dependent kinase inhibitor 2A (CDKN2A) and adenomatous polyposis coli (APC) genes, had been confirmed in non-neoplastic gastric mucosa when undergoing endoscopic submucosal dissection (ESD) for early GC. At the start of surveillance, the numbers of positive subjects were as follows: GX, 59 (51.3%); MSI, 48 (41.7%); hMLH1, 37 (32.2%); CDKN2A, 7 (6.1%); APC, 18 (15.7%). After ESD treatment, synchronous/metachronous GCs occurred in patients with the following positive factors: GX, 16 (27.1%); MSI, 7 (14.6%); hMLH1, 6 (16.2%); CDKN2A, 3 (42.9%); APC, 3 (16.7%). The presence of GX had no significant relationship to positivity for MSI or methylation of hMLH1, CDKN2A or APC. GX was significantly (p = 0.0059) and independently (hazard ratio, 3.275; 95% confidence interval, 1.134–9.346) predictive for the development of synchronous/metachronous GC, whereas those genetic alterations were not predictive. GX is a simple and powerful marker for predicting the development of synchronous or metachronous GC. Full article

(This article belongs to the Special Issue Gastrointestinal Malignancies: Screening, Diagnosis, and Treatment)

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16 pages, 3169 KiB

Open AccessArticle

Vimentin-Positive Circulating Tumor Cells as Diagnostic and Prognostic Biomarkers in Patients with Biliary Tract Cancer

by Sung Yong Han, Sung Hee Park, Hyun Suk Ko, Aelee Jang, Hyung Il Seo, So Jeong Lee, Gwang Ha Kim and Dong Uk Kim

J. Clin. Med. 2021, 10(19), 4435; https://doi.org/10.3390/jcm10194435 - 27 Sep 2021

Cited by 3 | Viewed by 1664

Abstract

Biliary tract cancer (BTC) has poor prognosis; thus, early diagnosis is important to decrease mortality. Although vimentin-positive circulating tumor cells (V-CTCs) are a good candidate for diagnostic and prognostic biomarkers, studies on the topic are limited. We aimed to evaluate the diagnostic efficacy [...] Read more.

Biliary tract cancer (BTC) has poor prognosis; thus, early diagnosis is important to decrease mortality. Although vimentin-positive circulating tumor cells (V-CTCs) are a good candidate for diagnostic and prognostic biomarkers, studies on the topic are limited. We aimed to evaluate the diagnostic efficacy of V-CTCs between BTC and benign biliary disease (BBD) and determine the prognostic value of V-CTCs in BTC patients. We recruited 69 participants who had BTCs and BBDs from a single tertiary referral center. We analyzed CTCs and V-CTCs in peripheral blood using the CD-PRIME^TM system. Seven patients were excluded due to a technical failure of CTC detection. CTCs were detected in all 62 patients. CTC count > 40/mL blood (55.8% vs. 20%, p = 0.039), V-CTC count > 15/mL blood (57.7% vs. 10%, p = 0.005), and V-CTC/CTC ratio > 40% (48.1% vs. 10%, p = 0.025) were significantly different between BTCs and BBDs. Two or more of these three parameters (61.5% vs. 10%, p = 0.002) increased the accuracy. A combination of CTC markers with CA19-9 and biopsy increased the accuracy (90.4% vs. 10%, p = 0.000). V-CTC > 50/mL blood was a significant factor affecting survival (140 (66.6–213.3) vs. 253 (163.9–342.1) days, p = 0.008). V-CTC could be a potential biomarker for early diagnosis and predicting prognosis in patients with BTC. Full article

(This article belongs to the Special Issue Gastrointestinal Malignancies: Screening, Diagnosis, and Treatment)

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15 pages, 857 KiB

Open AccessArticle

Clinical Limitations of Tissue Annexin A2 Level as a Predictor of Postoperative Overall Survival in Patients with Hepatocellular Carcinoma

by Shu-Wei Huang, Yen-Chin Chen, Yang-Hsiang Lin and Chau-Ting Yeh

J. Clin. Med. 2021, 10(18), 4158; https://doi.org/10.3390/jcm10184158 - 15 Sep 2021

Cited by 4 | Viewed by 1526

Abstract

Hepatocellular carcinoma (HCC) is the second common cause of cancer-related death in Taiwan. Tumor recurrence is frequently observed in HCC patients receiving surgical resection, resulting in unsatisfactory overall survival (OS). Therefore, it is pivotal to identify effective prognostic makers, so that intensive surveillance [...] Read more.

Hepatocellular carcinoma (HCC) is the second common cause of cancer-related death in Taiwan. Tumor recurrence is frequently observed in HCC patients receiving surgical resection, resulting in unsatisfactory overall survival (OS). Therefore, it is pivotal to identify effective prognostic makers, so that intensive surveillance or adjuvant treatments can be applied to predictively unfavorable patients. Previous studies indicated that Annexin A2 (ANXA2) was an effective prognostic marker in several cancers, including HCC. However, the prognostic value of ANXA2 in Taiwanese HCC patients remains unclear, where a great proportion of patients had chronic hepatitis B with liver cirrhosis. Here, ANXA2 was highly expressed in HCC tissues compared with para-neoplastic noncancerous tissues. Furthermore, high ANXA2 expression in HCC tissues independently predicted shorter OS. In subgroup analysis, however, ANXA2 expression could not effectively predict OS in the following subgroups: female, age > 65 years old, Child–Pugh classification B, hepatitis B virus surface antigen negative or anti-hepatitis C antibody positive, alcoholism, tumor number >1, presence of micro- or macrovascular invasion, absence of capsule, non-cirrhosis and high alpha-fetoprotein. In conclusion, ANXA2 expression in HCC tissues could predict postoperative OS. However, the predictive value was limited in patients with specific clinical conditions. Full article

(This article belongs to the Special Issue Gastrointestinal Malignancies: Screening, Diagnosis, and Treatment)

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13 pages, 584 KiB

Open AccessArticle

Metabolic Effects of Gastrectomy and Duodenal Bypass in Early Gastric Cancer Patients with T2DM: A Prospective Single-Center Cohort Study

by Young Ki Lee, Eun Kyung Lee, You Jin Lee, Bang Wool Eom, Hong Man Yoon, Young-Il Kim, Soo Jeong Cho, Jong Yeul Lee, Chan Gyoo Kim, Sun-Young Kong, Min Kyong Yoo, Yul Hwangbo, Young-Woo Kim, Il Ju Choi, Hak Jin Kim, Mi Hyang Kwak and Keun Won Ryu

J. Clin. Med. 2021, 10(17), 4008; https://doi.org/10.3390/jcm10174008 - 04 Sep 2021

Cited by 1 | Viewed by 1904

Abstract

We evaluated the metabolic effects of gastrectomies and endoscopic submucosal dissections (ESDs) in early gastric cancer (EGC) patients with type 2 diabetes mellitus (T2DM). Forty-one EGC patients with T2DM undergoing gastrectomy or ESD were prospectively evaluated. Metabolic parameters in the patients who underwent [...] Read more.

We evaluated the metabolic effects of gastrectomies and endoscopic submucosal dissections (ESDs) in early gastric cancer (EGC) patients with type 2 diabetes mellitus (T2DM). Forty-one EGC patients with T2DM undergoing gastrectomy or ESD were prospectively evaluated. Metabolic parameters in the patients who underwent gastrectomy with and without a duodenal bypass (groups 1 and 2, n = 24 and n = 5, respectively) were compared with those in patients who underwent ESD (control, n = 12). After 1 year, the proportions of improved/equivocal/worsened glycemic control were 62.5%/29.2%/8.3% in group 1, 40.0%/60.0%/0.0% in group 2, and 16.7%/50.0%/33.3% in the controls, respectively (p = 0.046). The multivariable ordered logistic regression analysis results showed that both groups had better 1-year glycemic control. Groups 1 and 2 showed a significant reduction in postprandial glucose (−97.9 and −67.8 mg/dL), body mass index (−2.1 and −2.3 kg/m²), and glycosylated hemoglobin (group 1 only, −0.5% point) (all p < 0.05). Furthermore, improvements in group 1 were more prominent when preoperative leptin levels were high (p for interaction < 0.05). Metabolic improvements in both groups were also observed for insulin resistance, leptin, plasminogen activator inhibitor-1, and resistin. Gastrectomy improved glycemic control and various metabolic parameters in EGC patients with T2DM. Patients with high leptin levels may experience greater metabolic benefits from gastrectomy with duodenal bypass. Full article

(This article belongs to the Special Issue Gastrointestinal Malignancies: Screening, Diagnosis, and Treatment)

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10 pages, 1867 KiB

Open AccessArticle

Prevalence and Clinical Implications of Ascites in Gastric Cancer Patients after Curative Surgery

by Ju-Hee Lee, Sung-Joon Kwon, Mimi Kim and Bo-Kyeong Kang

J. Clin. Med. 2021, 10(16), 3557; https://doi.org/10.3390/jcm10163557 - 13 Aug 2021

Cited by 1 | Viewed by 3980

Abstract

We aimed to determine the frequency and clinical significance of ascites that developed during the follow-up period in patients who underwent curative resection for gastric cancer. The study included 577 patients with gastric cancer who underwent curative gastrectomy. Among them, 184 showed ascites [...] Read more.

We aimed to determine the frequency and clinical significance of ascites that developed during the follow-up period in patients who underwent curative resection for gastric cancer. The study included 577 patients with gastric cancer who underwent curative gastrectomy. Among them, 184 showed ascites in postoperative follow-up images. Benign ascites was observed in 131 of 490 patients without recurrence, 48 patients (of 87) with recurrence had malignancy-related ascites, and the remaining 5 patients had ascites only prior to recurrence. In most patients without recurrence (97.7%) and in 50% of patients with malignancy-related ascites, the ascites was small in volume and located in the pelvic cavity at the time that it was first identified. However, with the exception of nine patients, malignancy-related pelvic ascites occurred simultaneously or after obvious recurrence. Of those nine patients who had minimal pelvic ascites before obvious recurrence, only one had a clear association with a malignancy-related ascites. In the multivariate analysis, an age of ≤45 was the only independent risk factor for the occurrence of benign ascites. A small volume of pelvic ascites fluid is common in young gastric cancer patients who do not have recurrence after gastrectomy, regardless of sex. It is rare for ascites to be the first manifestation of recurrence. Full article

(This article belongs to the Special Issue Gastrointestinal Malignancies: Screening, Diagnosis, and Treatment)

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9 pages, 612 KiB

Open AccessArticle

Colorectal Cancer Risk in Women with Gynecologic Cancers—A Population Retrospective Cohort Study

by Szu-Chia Liao, Hong-Zen Yeh, Chi-Sen Chang, Wei-Chih Chen, Chih-Hsin Muo and Fung-Chang Sung

J. Clin. Med. 2021, 10(14), 3127; https://doi.org/10.3390/jcm10143127 - 15 Jul 2021

Cited by 1 | Viewed by 1617

Abstract

We conducted a retrospective cohort study to evaluate the subsequent colorectal cancer (CRC) risk for women with gynecologic malignancy using insurance claims data of Taiwan. We identified patients who survived cervical cancer (N = 25,370), endometrial cancer (N = 8149) and ovarian cancer [...] Read more.

We conducted a retrospective cohort study to evaluate the subsequent colorectal cancer (CRC) risk for women with gynecologic malignancy using insurance claims data of Taiwan. We identified patients who survived cervical cancer (N = 25,370), endometrial cancer (N = 8149) and ovarian cancer (N = 7933) newly diagnosed from 1998 to 2010, and randomly selected comparisons (N = 165,808) without cancer, matched by age and diagnosis date. By the end of 2011, the incidence and hazard ratio (HR) of CRC were estimated. We found that CRC incidence rates were 1.26-, 2.20-, and 1.61-fold higher in women with cervical, endometrial and ovarian cancers, respectively, than in comparisons (1.09/1000 person–years). The CRC incidence increased with age. Higher adjusted HRs of CRC appeared within 3 years for women with endometrial and ovarian cancers, but not until the 4th to 7th years of follow up for cervical cancer survivals. Cancer treatments could reduce CRC risks, but not significantly. However, ovarian cancer patients receiving surgery alone had an incidence of 3.33/1000 person–years for CRC with an adjusted HR of 3.79 (95% CI 1.11–12.9) compared to patients without any treatment. In conclusion, gynecologic cancer patients are at an increased risk of developing CRC, sooner for those with endometrial or ovarian cancer than those with cervical cancer. Full article

(This article belongs to the Special Issue Gastrointestinal Malignancies: Screening, Diagnosis, and Treatment)

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11 pages, 1069 KiB

Open AccessArticle

Association between Hepatitis C Virus Infection and Esophageal Cancer: An Asian Nationwide Population-Based Cohort Study

by Yin-Yi Chu, Jur-Shan Cheng, Ting-Shu Wu, Chun-Wei Chen, Ming-Yu Chang, Hsin-Ping Ku, Rong-Nan Chien and Ming-Ling Chang

J. Clin. Med. 2021, 10(11), 2395; https://doi.org/10.3390/jcm10112395 - 28 May 2021

Cited by 4 | Viewed by 1655

Abstract

Background: Hepatitis C virus (HCV) infection causes many extrahepatic cancers, and whether HCV infection is associated with esophageal cancer development remains inconclusive. Methods: A nationwide population-based cohort study of the Taiwan National Health Insurance Research Database (TNHIRD) was conducted. Results: From 2003 to [...] Read more.

Background: Hepatitis C virus (HCV) infection causes many extrahepatic cancers, and whether HCV infection is associated with esophageal cancer development remains inconclusive. Methods: A nationwide population-based cohort study of the Taiwan National Health Insurance Research Database (TNHIRD) was conducted. Results: From 2003 to 2012, of 11,895,993 patients, three 1:1:1 propensity score-matched cohorts, including HCV-treated (interferon-based therapy ≧6 months, n = 9047), HCV-untreated (n = 9047), and HCV-uninfected cohorts (n = 9047), were enrolled. The HCV-untreated cohort had the highest 9-year cumulative incidence of esophageal cancer among the three cohorts (0.174%; 95% confidence interval (CI): 0.068–0.395) (p = 0.0292). However, no difference in cumulative incidences was identified between the HCV-treated (0.019%; 0.002–0.109%) and HCV-uninfected cohorts (0.035%; 0.007–0.133%) (p = 0.5964). The multivariate analysis showed that HCV positivity (hazard ratio (HR): 5.1, 95% CI HR: 1.39–18.51) and male sex (HR: 8.897; 95% CI HR: 1.194–66.323) were independently associated with the development of esophageal cancer. Of the three cohorts, the HCV-untreated cohort had the highest cumulative incidence of overall mortality at 9 years (21.459%, 95% CI: 18.599–24.460) (p < 0.0001), and the HCV-treated (12.422%, 95% CI: 8.653–16.905%) and HCV-uninfected cohorts (5.545%, 95% CI: 4.225–7.108%) yielded indifferent cumulative mortality incidences (p = 0.1234). Conclusions: Although HCV positivity and male sex were independent factors associated with esophageal cancer development, whether HCV infection is the true culprit or a bystander for developing esophageal cancer remains to be further investigated. Interferon-based anti-HCV therapy might attenuate esophageal risk and decrease overall mortality in HCV-infected patients. Full article

(This article belongs to the Special Issue Gastrointestinal Malignancies: Screening, Diagnosis, and Treatment)

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