Published in:
01-03-2020 | Esophageal Cancer | Thoracic Oncology
Tooth Loss Predicts Long-Term Prognosis of Esophageal Cancer After Esophagectomy
Authors:
Susumu Miura, MD, Tetsu Nakamura, PhD, MD, Takumi Hasegawa, PhD, DDS, Yukiko Miura, MD, Gosuke Takiguchi, PhD, MD, Naoki Urakawa, PhD, MD, Hiroshi Hasegawa, PhD, MD, Masashi Yamamoto, PhD, MD, Shingo Kanaji, PhD, MD, Yoshiko Matsuda, PhD, MD, Kimihiro Yamashita, PhD, MD, Takeru Matsuda, PhD, MD, Taro Oshikiri, PhD, MD, Satoshi Suzuki, PhD, MD, Masaya Akashi, PhD, DDS, Yoshihiro Kakeji, PhD, MD
Published in:
Annals of Surgical Oncology
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Issue 3/2020
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Abstract
Background
Oral health is associated with various diseases, including cancer. Tooth loss is a simple and objective index of oral health.
Objective
The purpose of this study was to investigate the association between preoperative tooth loss and esophageal cancer prognosis after esophagectomy.
Methods
This study included 191 patients who underwent esophagectomy for esophageal cancer after perioperative dental evaluation and oral care at Kobe University Hospital from April 2011 to March 2016. Patients were divided into two groups: Group A (tooth loss < 7) and Group B (tooth loss ≥ 7). Three-year overall survival (OS) and multivariate analysis were performed, along with subgroup analysis for elderly patients (age ≥ 65 years).
Results
The 3-year OS rate was 68.1% in Group A (104 patients) and 49.2% in Group B (87 patients). Group A had significantly higher OS than Group B (p = 0.002), and there were no significant differences in sex and clinical T or N stage between the two groups. However, the mean age of Group A was younger than that of Group B (64.2 vs. 68.5 years; p = 0.0002). Among elderly patients, the 3-year OS rate was 68.2% in Group A (55 patients) and 45.1% in Group B (65 patients) [p = 0.003]. Multivariate analysis that included age demonstrated that tooth loss is an independent prognostic factor (hazard ratio 1.87, 95% confidence interval 1.22–2.87), in addition to clinical T stage and preoperative serum albumin.
Conclusion
Tooth loss is an independent prognostic factor for esophageal cancer after esophagectomy.