MetALD Was an Independent Risk Factor for the Recurrence of Early Esophageal Squamous Cell Carcinoma After Endoscopic...

Area of Science:

• Gastroenterology and Hepatology
• Oncology
• Metabolic Diseases

Background:

• Alcohol consumption and metabolic dysfunction are known risk factors for esophageal squamous cell carcinoma (ESCC).
• The combined impact of these factors on ESCC recurrence post-treatment remains unclear.
• Metabolic dysfunction-associated steatotic liver disease (MASLD) and moderate alcohol intake (MetALD) are specific conditions of interest.

Purpose of the Study:

• To determine if MetALD independently predicts ESCC recurrence after curative endoscopic submucosal dissection (ESD).
• To investigate the synergistic effects of MASLD and moderate alcohol consumption on ESCC recurrence.

Main Methods:

• A multicenter cohort study of 63 early-stage ESCC patients undergoing curative ESD.
• Patients were categorized based on MetALD status (MASLD with moderate alcohol intake).
• Recurrence-free survival was analyzed using multivariable Cox regression, decision trees, random forests, and directed acyclic graphs.

Main Results:

• 25.4% of patients experienced recurrence during a median 2.3-year follow-up.
• Alcohol non-abstinence and MetALD were identified as independent predictors of ESCC recurrence.
• MetALD patients who did not abstain from alcohol had a significantly higher recurrence rate (54%) compared to those without steatotic liver disease (27%).

Conclusions:

• MetALD is an independent risk factor for ESCC recurrence following curative ESD, particularly in non-abstinent individuals.
• Moderate alcohol intake combined with MASLD demonstrates a synergistic oncogenic effect.
• Lifestyle and metabolic interventions are vital for managing patients post-ESD, especially those with MetALD.