Background And Aims: Risk factors for subtypes of esophageal and gastric cancer recently have been identified, but their effect on survival is unknown.
Methods: Incident cases (n = 1142) from a population-based case-control study were followed-up from diagnosis (1993-1995) until 2000. Cox regression models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for esophageal and gastric cancer in relation to prediagnostic factors.
Results: Relative to distant stage, esophageal adenocarcinoma (EA) patients with localized disease had a decreased risk for death (HR, .22; 95% CI, .15-.31), followed by those with regional spread (HR, .32; 95% CI, .23-.45). Similar patterns were seen for the other tumor types. Except for other (non-cardia) gastric adenocarcinomas (OGA), higher household income (> or =15,000 US dollars/y vs. <15,000 US dollars/y) was associated with a 33%-38% decrease in risk for death. Prediagnosis body mass index (BMI) between 25 and 29.9 kg/m 2 was associated with longer survival for EA and OGA patients (EA: HR, .67; 95% CI, .51-.88) vs. BMI <25 kg/m(2). Women with esophageal squamous cell carcinoma (ES) and OGA experienced longer survival compared with men. Age, education, cigarette smoking, alcohol intake, gastroesophageal reflux disease, and nonsteroidal anti-inflammatory drug use did not consistently predict survival.
Conclusions: Predictors of lengthened esophageal and gastric cancer survival included higher income (except in OGA), overweight (among EA and OGA patients), and female sex (among ES and OGA patients).
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http://dx.doi.org/10.1016/s1542-3565(04)00613-5 | DOI Listing |
Heart Lung Circ
January 2025
Department of Cardiology, St Vincent's Hospital Melbourne, Melbourne, Vic, Australia; Heart, Exercise and Research Trials (HEART) Laboratory, St Vincent's Institute of Medical Research, Melbourne, Vic, Australia; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Vic, Australia.
Background: Glucagon-like peptide-1 receptor agonist (GLP-1RA) therapies are increasingly used for the treatment of type 2 diabetes mellitus and obesity. Despite growing awareness of potentially increased risk of pulmonary aspiration due to delayed gastric emptying, the risks and benefits of their perioperative use in patients undergoing cardiac procedures remains unexplored. A scoping review was performed to investigate the perioperative GLP-1RA use in patients undergoing cardiac procedures and recommendations.
View Article and Find Full Text PDFAm Fam Physician
January 2025
Duke University School of Medicine, Durham, N.C.
Gastroesophageal reflux is a common physiologic event in infants in which gastric contents pass from the stomach into the esophagus. Gastroesophageal reflux may be asymptomatic or cause regurgitation or "spit up." This occurs daily in approximately 40% of infants.
View Article and Find Full Text PDFJ Gastric Cancer
January 2025
Department of Gastroenterological Surgery, Cancer Institute Hospital Ariake, Tokyo, Japan.
Proximal gastrectomy (PG) has reemerged as a viable surgical option for managing proximal gastric cancer and gastroesophageal junction cancer, particularly for early-stage tumors, offering potential advantages over total gastrectomy (TG). This review examines the evolution of PG, emphasizing surgical techniques and outcomes. Although PG was initially abandoned due to postoperative complications such as reflux esophagitis, advances in reconstruction methods, such as the double-flap technique and double-tract reconstruction, have significantly improved patient quality of life and reduced complications.
View Article and Find Full Text PDFLangenbecks Arch Surg
January 2025
Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215008, China.
Background: The selection of an appropriate gastrointestinal (GI) reconstruction procedure after proximal gastrectomy (PG) has long been a challenge. Surgeons have had a long history of exploring anti-reflux gastroesophageal anastomosis. The aim of this article is to systematically summarize the anti-reflux principles of GI reconstructive procedures through a review of the previous literature and to provide a theoretical basis for clinicians to select or innovate procedures.
View Article and Find Full Text PDFWorld J Surg Oncol
January 2025
General Surgeon, Department of General Surgery, Clínica Universitaria Colombia, Bogotá, D.C., Colombia.
Background: Gastric cancer remains a major global health challenge, ranking fourth in cancer-related deaths. Total gastrectomy with lymphadenectomy is the standard treatment, with advancements in surgery shifting towards minimally invasive techniques to reduce surgical trauma and metabolic response. Esophagojejunal anastomotic leak is a frequent complication of gastrectomy, significantly increasing morbidity and mortality rates by up to 64%.
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