Relevance of both individual risk factors and occupational exposure in cancer survival studies : The Example of Intestinal Type Sinonasal Adenocarcinoma
✍ Scribed by Dominique Tripodi; Christophe Ferron; Olivier Malard; Claude Beauvillain de Montreuil; Lucie Planche; Veronique Sebille-Rivain; Claude Roedlich; Sylvia Quéméner; Karine Renaudin; Claire Longuenesse; Christian Verger; Khaled Meflah; Catherine Gratas; Christian Géraut
- Publisher
- John Wiley and Sons
- Year
- 2011
- Tongue
- English
- Weight
- 177 KB
- Volume
- 121
- Category
- Article
- ISSN
- 0023-852X
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✦ Synopsis
Objectives/Hypothesis: Wood dust is a well-established risk factor for intestinal type sinonasal adenocarcinoma. The 5year overall survival has varied from 20% to 80% according T1-T4 stages; 5-year survival according to histologic subtype has varied from 20% to 50%.
To date, no study has evaluated whether environmental, occupational, and personal risk factors have any impact on both overall and cancer-specific survival. We aimed to determine whether exposure to carcinogenic risk factors besides wood exposure can influence the survival of patients with sinonasal ethmoid carcinoma.
Study Design: Retrospective cohort study of the association of survival data and occupational and personal carcinogenic risk factors.
Methods: All patients hospitalized for ethmoid adenocarcinoma at the Nantes University Hospital between 1988 and 2004 were included . Data concerning TNM classification, histology, type and quality of tumor resection at the macro-and microscopic level, and occupational and personal exposure to carcinogens were collected. Statistical analysis was conducted using univariate and multivariate linear regression.
Results: A total of 98 patients were included with a response rate of 98%. Data showed 86% of patients had been exposed to wood dust. The 5-year survival was 62%. We first identified four factors that independently influenced overall survival: diplopia (P ¼ .0159), spread to the orbit (P ¼ .0113), bilateral involvement (P ¼ .0134), TNM stage (P < .001). When the analysis included all occupational environmental factors (wood dust, solvent, and metals exposure) as well as personal risk factors, the length of exposure to metals (P ¼ .0307) and tobacco exposure (P ¼ .0031) also were found to influence 5-year overall survival. We identified high prevalence of colon cancer (4%) and double cancer (18%).
Conclusions: We showed exposure to both environmental (tobacco) and occupational (metal dust) factors could influence survival in the diagnosis of a cancer. Our study suggests that screening for colon cancer should be offered to wood dust workers. A prospective multicentric study should be necessary to confirm our results.