Outcomes of Helicobacter pylori (HP) infection in esophageal cancer (EC): A 5-year nationwide analysis.
Journal of Clinical Oncology(2023)
摘要
e16079 Background: EC is a fatal condition, and recent literature suggests the association of HP with esophageal adenocarcinoma. In this study, we elucidate the outcomes of HP infection in EC. Methods: This is a retrospective longitudinal study from 2016-2020, using the nationwide inpatient sample database in the United States (US). Patients with EC with and without HP infection were selected. The baseline characteristics were compared using a T-test and Chi-Square. Multivariate regression analysis was applied to estimate the outcomes (length of hospital stay (LOS), mortality, and morbidity) while adjusting for patient and hospital confounders. We used STATA Version 17.0 for data analysis. The p-value was set at p < 0.05 for statistical significance. Results: In total, 69,144 patients with esophageal cancer were identified; among them, 0.3% (n= 220) had an HP infection. The highest prevalence of cases was seen in the Southern US (35.7%). The average LOS was 3.39 days (p = 0.01), and reduced mortality (p = 0.002). The Charlson comorbidity index (CCI) score was 3 or more for 74.2% (p=0.005). With regards to outcomes, 16.4% (p< 0.05) had esophageal obstruction, 20.2% (p< 0.05) had anemia, and 8% (p < 0.01) underwent esophagectomy. However, no significant differences in the rates of hematemesis 4.4% (p=0.15), melena 2.5% (p=0.28), or esophageal perforation 1.2% (p=0.45) were reported (Table 1). When compared to patients with HP infection, no statistically significant difference was found in the outcomes. Conclusions: Our study indicates a significantly increased prevalence of EC in the southern regions of the US, which may be attributed to regional differences in lifestyle, diet, and access to healthcare. The study population was predominantly admitted with a CCI score of 3, highlighting the burden of comorbid conditions. EC patients had decreased LOS and mortality trends in the past 5 years. Moreover, EC was associated with higher rates of esophageal obstruction and anemia. However, no effect on hematemesis, melena, and esophageal perforation was appreciated, and no statistically significant difference was found in the outcomes of EC with HP infection.[Table: see text]
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关键词
esophageal cancer
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