Abstract
BackgroundThe effects of dietary factors on prognosis of esophageal cancer remain unclear. This systematic review and meta-analysis aimed to assess the association between dietary intake and the risk of mortality among patients with esophageal cancer.MethodsSix electronic databases (PubMed, Web of Science, OVID, ProQuest, CNKI and Wanfang) were searched for studies published up to Oct. 2019 that examined the association between dietary intake and all-cause mortality, esophageal cancer-specific mortality and esophageal cancer recurrence. The pooled hazard ratio (HR) with 95% confidence interval (CI) were derived by comparing the highest with the lowest categories of each dietary item and by using random effect models.ResultsA total of 15 cohort studies were included in this study and all reported pre-diagnosis dietary exposure; two focused on dietary folate, 12 on alcohol consumption and three on other dietary components (sugary beverages, phytochemicals and preserved vegetables). When comparing the highest with the lowest categories, dietary folate intake was associated with a reduced risk of esophageal cancer-specific mortality in patients with esophageal squamous cell carcinoma (HR: 0.41, 95% CI: 0.25–0.69), with low heterogeneity (I2 = 0%, P = 0.788). When comparing the highest with the lowest categories of alcohol consumption, alcohol consumption was associated with an increased risk of all-cause mortality in patients with esophageal squamous cell carcinoma (HR: 1.29, 95% CI: 1.07–1.55; heterogeneity: I2 = 53%, P = 0.030), but this increased risk was not significant in patients with esophageal adenocarcinoma (HR = 1.05, 95% CI: 0.84–1.32).ConclusionsThis review with pre-diagnostic dietary exposure showed that dietary folate intake was associated with a reduced risk of mortality of esophageal squamous cell carcinoma, whereas alcohol consumption was associated with an increased risk. More studies are needed to investigate effect of dietary factors, especially post-diagnosis dietary consumption, on esophageal cancer prognosis.
Highlights
The effects of dietary factors on prognosis of esophageal cancer remain unclear
A meta-analysis showed that pre-diagnosis alcohol drinking increased risk of death in esophageal squamous cell carcinoma (ESCC) rather than in Esophageal adenocarcinoma (EAC) [16], some new evidence has emerged after this study published and the pooled results are needed to be updated
Eleven studies focused on ESCC [13,14,15, 23,24,25,26,27, 29, 30, 32], 5 on EAC [12,13,14, 23, 31], and 3 on Esophageal cancer (EC) [12, 28, 33]
Summary
The effects of dietary factors on prognosis of esophageal cancer remain unclear. This systematic review and meta-analysis aimed to assess the association between dietary intake and the risk of mortality among patients with esophageal cancer. Increasing evidence is highlighting the pivotal effects of nutritional factors on cancer prognosis and survival: natural ingredients such as lycopene and beta-carotene in the plant food could inhibit EC109 cell viability [7], dietary interventions could improve diet quality in cancer survivors [8], and nutritional support could improve esophageal cancer prognosis by improving treatment compliance, reducing toxicity and enhancing the immune response [9]. A meta-analysis showed that pre-diagnosis alcohol drinking increased risk of death in ESCC rather than in EAC [16], some new evidence has emerged after this study published and the pooled results are needed to be updated
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
