Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Esophagus
Published in: Esophagus 2/2024

Open Access 20-02-2024 | Esophagus Resection | Original Article

Pretreatment periodontitis is predictive of a poorer prognosis after esophagectomy for esophageal cancer

Authors: Shu Nozaki, Yusuke Sato, Hiroshi Takano, Kyoko Nomura, Akiyuki Wakita, Jiajia Liu, Yushi Nagaki, Ryohei Sasamori, Yoshihiro Sasaki, Tsukasa Takahashi, Hidemitsu Igarashi, Yasunori Konno, Masayuki Fukuda, Yoshihiro Minamiya

Published in: Esophagus | Issue 2/2024

Login to get access

Abstract

Background

Poor oral health is an independent risk factor for upper-aerodigestive tract cancers, including esophageal cancer. Several studies have investigated short-term outcomes after esophagectomy and the impact of periodontal disease, but few have examined the impact of periodontal disease on long-term outcomes. The purpose of this study was to investigate the rate of periodontitis among esophagectomy patients and the prognostic value of periodontitis and its effect on prognosis after esophagectomy.

Methods

A total of 508 patients who underwent esophagectomy received oral health care from a dentist before cancer treatment at Akita University Hospital between January 2009 and December 2021. We assessed the presence and severity of the patients’ periodontitis and divided them into no-periodontitis, mild periodontitis, severe periodontitis and edentulous jaw groups. We then assessed 10-year overall survival (OS) and disease-specific survival (DSS) and determined whether periodontitis was an independent prognostic factor affecting OS and DSS.

Results

We found that 101 (19.9%) patients had no periodontitis, 207 (40.8%) had mild periodontitis, 176 (34.6%) had severe periodontitis requiring tooth extraction, and 24 (4.7%) had edentulous jaw. Both OS and DSS were significantly poorer in the periodontitis than no-periodontitis group (p < 0.001). In detail, the edentulous jaw group had the poorest prognosis (p < 0.001). Multivariate analysis showed that periodontitis was an independent risk factor affecting OS and DSS.

Conclusion

Esophageal cancer patients had a high prevalence of periodontitis. Moreover, the presence of periodontitis and severity of periodontitis are independent risk factors contributing to a poorer prognosis after esophagectomy.
Appendix
Available only for authorised users
Literature
1.
2.
Arnold M, Soerjomataram I, Ferlay J, et al. Global incidence of oesophageal cancer by histological subtype in 2012. Gut. 2015;64:381–7.CrossRefPubMed
3.
Morita M, Kumashiro R, Kubo N, et al. Alcohol drinking, cigarette smoking, and the development of squamous cell carcinoma of the esophagus: epidemiology, clinical findings, and prevention. Int J Clin Oncol. 2010;15(2):126–34.CrossRefPubMed
4.
Uhlenhopp DJ, Then EO, Sunkara T, et al. Epidemiology of esophageal cancer: update in global trends, etiology and risk factors. Clin J Gastroenterol. 2020;13(6):1010–21.CrossRefPubMed
5.
Ahrens W, Pohlabeln H, Foraita R, et al. Oral health, dental care and mouthwash associated with upper aerodigestive tract cancer risk in Europe: the ARCAGE study. Oral Oncol. 2014;50(6):616–25.CrossRefPubMed
6.
Baba Y, Iwatsuki M, Yoshida N, et al. Review of the gut microbiome and esophageal cancer: pathogenesis and potential clinical implications. Ann Gastroenterol Surg. 2017;1(2):99–104.CrossRefPubMedPubMedCentral
7.
8.
Awano S, Ansai T, Takata Y, et al. Oral health and mortality risk from pneumonia in the elderly. J Dent Res. 2008;87:334–9.CrossRefPubMed
9.
Abnet CC, Qiao YL, Dawsey SM, et al. Tooth loss is associated with increased risk of total death and death from upper gastrointestinal cancer, heart disease, and stroke in a Chinese population-based cohort. Int J Epidemiol. 2005;34(2):467–74.CrossRefPubMed
10.
Holmlund A, Holm G, Lind L. Number of teeth as a predictor of cardiovascular mortality in a cohort of 7,674 subjects followed for 12 years. J Periodontol. 2010;81(6):870–6.CrossRefPubMed
11.
Sato Y, Motoyama S, Takano H, et al. Esophageal cancer patients have a high incidence of severe periodontitis and preoperative dental care reduces the likelihood of severe pneumonia after esophagectomy. Dig Surg. 2016;33(6):495–502.CrossRefPubMed
12.
Miura S, Nakamura T, Hasegawa T, et al. Tooth loss predicts long-term prognosis of esophageal cancer after esophagectomy. Ann Surg Oncol. 2020;27(3):683–90.CrossRefPubMed
13.
Watanabe T, Sohda M, Kim M, et al. Preoperative evaluation of oral hygiene may predict the overall survival of patients with esophageal cancer. Esophagus. 2023;20:99–108.CrossRefPubMed
14.
Saeki H, Sohda M, Sakai M, et al. Role of surgery in multidisciplinary treatment strategies for locally advanced esophageal squamous cell carcinoma. Ann Gastroenterol Surg. 2020;4:490–7.CrossRefPubMedPubMedCentral
15.
Watanabe M, Okamura A, Toihata T, et al. Recent progress in perioperative management of patients undergoing esophagectomy for esophageal cancer. Esophagus. 2018;15:160–4.CrossRefPubMed
16.
Akutsu Y, Matsubara H, Shuto K, et al. Pre-operative dental brushing can reduce the risk of postoperative pneumonia in esophageal cancer patients. Surgery. 2010;147:497–502.CrossRefPubMed
17.
Sobin L, Gospodarowicz M, Wittekind C. International union against cancer. In: TNM classification of malignant tumors. 7th ed. Chichester: Wiley-Blackwell; 2009.
18.
Miller PD Jr. A classification of marginal tissue recession. Int J Periodontics Restor Dent. 1985;5:8–13.
19.
Sato Y, Motoyama S, Wada Y, et al. Neoadjuvant chemoradiotherapy followed by esophagectomy with three-field lymph node dissection for thoracic esophageal squamous cell carcinoma patients with clinical stage III and with supraclavicular lymph node metastasis. Cancers (Basel). 2021;13(5):983.CrossRefPubMed
20.
Sato Y, Motoyama S, Maruyama K, et al. A second malignancy is the major cause of death among thoracic squamous cell esophageal cancer patients negative for lymph node involvement. J Am Coll Surg. 2005;201:188–93.CrossRefPubMed
21.
Sato Y, Motoyama S, Nanjo H, et al. CXCL10 expression status is prognostic in patients with advanced thoracic esophageal squamous cell carcinoma. Ann Surg Oncol. 2016;23:936–42.CrossRefPubMed
22.
Arora M, Weuve J, Fall K, et al. An exploration of shared genetic risk factors between periodontal disease and cancers: a prospective co-twin study. Am J Epidemiol. 2010;171(2):253–9.CrossRefPubMed
23.
Michaud DS, Lu J, Peacock-Villada AY, et al. Periodontal disease assessed using clinical dental measurements and cancer risk in the ARIC study. J Natl Cancer Inst. 2018;110(8):843–54.CrossRefPubMedPubMedCentral
24.
Michaud DS, Liu Y, Meyer M, et al. Periodontal disease, tooth loss, and cancer risk in male health professionals: a prospective cohort study. Lancet Oncol. 2008;9(6):550–8.CrossRefPubMedPubMedCentral
25.
Shakeri R, Malekzadeh R, Etemadi A, et al. Association of tooth loss and oral hygiene with risk of gastric adenocarcinoma. Cancer Prev Res (Phila). 2013;6(5):477–82.CrossRefPubMed
26.
27.
Xu W, Zhou W, Wang H, et al. Roles of Porphyromonas gingivalis and its virulence factors in periodontitis. Adv Protein Chem Struct Biol. 2020;120:45–84.CrossRefPubMedPubMedCentral
28.
Lau MC, Ng KY, Wong TL, et al. FSTL1 promotes metastasis and chemoresistance in esophageal squamous cell carcinoma through NFκB-BMP signaling cross-talk. Cancer Res. 2017;77(21):5886–99.CrossRefPubMed
29.
Zu Y, Ping W, Deng T, et al. Lipopolysaccharide-induced toll-like receptor 4 signaling in esophageal squamous cell carcinoma promotes tumor proliferation and regulates inflammatory cytokines expression. Dis Esophagus. 2017;30(2):1–8.PubMed
30.
Chen MF, Lu MS, Hsieh CC, et al. Porphyromonas gingivalis promotes tumor progression in esophageal squamous cell carcinoma. Cell Oncol (Dordr). 2021;44(2):373–84.CrossRefPubMed
31.
Sato Y, Motoyama S, Wakita A, et al. High TLR4 expression predicts a poor prognosis after esophagectomy for advanced thoracic esophageal squamous cell carcinoma. Esophagus. 2020;17:408–16.CrossRefPubMed
32.
Sato Y, Wakita A, Maeda E, et al. High TLR6 expression status predicts a more favorable prognosis after esophagectomy for locally advanced thoracic esophageal squamous cell carcinoma. Curr Oncol. 2023;30:4724–35.CrossRefPubMedPubMedCentral
33.
Yue Y, Wang S, Shi J, et al. Effects of Lactobacillus acidophilus KLDS1.0901 on proliferation and apoptosis of colon cancer cells. Front Microbiol. 2022;12: 788040.CrossRefPubMedPubMedCentral
34.
Botta C, Spyridopoulou K, Bertolino M, et al. Lactiplantibacillus plantarum inhibits colon cancer cell proliferation as function of its butyrogenic capability. Biomed Pharmacother. 2022;149: 112755.CrossRefPubMed
35.
Zhang L, Yi H. Potential antitumor and anti-inflammatory activities of an extracellular polymeric substance (EPS) from Bacillus subtilis isolated from a housefly. Sci Rep. 2022;12:1383.CrossRefPubMedPubMedCentral
36.
37.
38.
Horinouchi T, Yoshida N, Toihata T, et al. Postoperative respiratory morbidity can adversely affect prognosis in thoracoscopic esophagectomy for esophageal cancer: a retrospective study. Surg Endosc. 2023;37:2104–11.CrossRefPubMed
39.
Yuda M, Yamashita K, Okamura A, et al. Influence of preoperative oropharyngeal microflora on the occurrence of postoperative pneumonia and survival in patients undergoing esophagectomy for esophageal cancer. Ann Surg. 2020;272(6):1035–43.CrossRefPubMed
Metadata
Title
Pretreatment periodontitis is predictive of a poorer prognosis after esophagectomy for esophageal cancer
Authors
Shu Nozaki
Yusuke Sato
Hiroshi Takano
Kyoko Nomura
Akiyuki Wakita
Jiajia Liu
Yushi Nagaki
Ryohei Sasamori
Yoshihiro Sasaki
Tsukasa Takahashi
Hidemitsu Igarashi
Yasunori Konno
Masayuki Fukuda
Yoshihiro Minamiya
Publication date
20-02-2024
Publisher
Springer Nature Singapore
Published in
Esophagus / Issue 2/2024
Print ISSN: 1612-9059
Electronic ISSN: 1612-9067
DOI
https://doi.org/10.1007/s10388-024-01045-z

Other articles of this Issue 2/2024

Esophagus 2/2024 Go to the issue

Review Article

Efficacy of thoracic endovascular aortic repair for aorto-esophageal fistula due to esophageal cancer: a systematic review and meta-analysis

Original Article

Routine image-enhanced endoscopic surveillance for metachronous esophageal squamous cell neoplasms in head and neck cancer patients

Original Article

Risk factors for venous thrombosis after esophagectomy

Original Article

The tumor cell-intrinsic cGAS–STING pathway is associated with the high density of CD8+ T cells after chemotherapy in esophageal squamous cell carcinoma

Review Article

Remarkable response as a new indicator for endoscopic evaluation of local efficacy of non-surgical treatments for esophageal cancer

Original Article

Refining postoperative monitoring of recurrent laryngeal nerve injury in esophagectomy patients through transcutaneous laryngeal ultrasonography
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine
Image Credits