Alcohol, Smoking, Related Biomarkers And Oesophageal Adenocarcinoma Survival: A Molecular Pathology Epidemiology Cohort Study In Northern Ireland

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Introduction

Cigarette smoking and alcohol consumption are associated with the development of multiple cancers, but evidence is lacking regarding their impact on cancer survival and in particular oesophageal adenocarcinoma survival.

Aims

To assess the impact of smoking and alcohol consumption on survival in oesophageal adenocarcinoma in a population-based study and assess the impact of these lifestyle factors on survival within biomarker groupings

Methods

Oesophageal adenocarcinoma specimens and clinical data were collected from 130 patients treated with neo-adjuvant chemotherapy prior to surgical resection at the Northern Ireland Cancer Centre between 2004 and 2012. Tissue microarrays were created and immunohistochemical staining for p53, HER2, GLUT-1 and CD8 was performed on triplicate tumour cores from each resection specimen. Survival analysis was calculated using Cox proportional hazards regression models.

Results

During a median of 2.5 (maximum 9) years of follow-up, 75 patients died. In adjusted analysis comparing ever with never alcohol consumption there was a non-significant increased risk of mortality in overall (HR 1.70 95% CI 0.95-3.04) and disease specific survival (HR 1.70 95% CI 0.93-3.11). There was no difference in survival in current or former smokers compared to never smokers. In biomarker analysis, there was a statistically significant worsened survival in patients who were ever drinkers and had GLUT1 positive (HR 2.5 95% CI 1.37-4.57) and CD8 positive tumours (HR 2.78 95% CI 1.31-5.89).

Conclusion

Ever alcohol consumption may have an impact on survival in patients with oesophageal adenocarcinoma and in particular those patients with CD8 and GLUT1 positive tumours. More studies with larger numbers need to be performed to investigate these findings further.