School of Public Health, Yale University, New Haven, CT 06520, USA.
J Cancer Surviv. 2010 Jun;4(2):101-9. doi: 10.1007/s11764-009-0111-4. Epub 2009 Dec 29.
Epidemiological studies have shown that moderate alcohol drinkers have a lower death rate for all causes. Alcohol drinking has also been associated with reduced risk of non-Hodgkin lymphoma (NHL). Here, we examined the role of alcohol consumption on NHL survival by type of alcohol consumed and NHL subtype.
A cohort of 575 female NHL incident cases diagnosed during 1996-2000 in Connecticut was followed-up for a median of 7.75 years. Demographic, clinical, and lifestyle information was collected at diagnosis. Survival analyses were conducted with Kaplan-Meier methods, and hazard ratios (HR) were estimated from Cox Proportional Hazards models.
Compared to never drinkers, wine drinkers experienced better overall survival (75% vs. 69% five-year survival rates, p-value for log-rank test = 0.030) and better disease free survival (70% vs. 67% five-year disease-free survival rates, p-value for log-rank test = 0.049). Analysis by NHL subtype shows that the favorable effect of wine consumption was mainly seen for patients diagnosed with diffuse large B-cell lymphoma (DLBCL) (wine drinkers for more than 25 years vs. never drinkers: HR = 0.36, 95% CI 0.14-0.94 for overall survival; HR = 0.38, 95% CI 0.16-0.94 for disease-free survival), and the adverse effect of liquor consumption was also observed among DLBCL patients (liquor drinkers vs. never drinkers: HR=2.49, 95% CI 1.26-4.93 for disease-free survival).
Our results suggest a moderate relationship between pre-diagnostic alcohol consumption and NHL survival, particularly for DLBCL. The results need to be replicated in larger studies.
Pre-diagnostic behaviors might impact the prognosis and survival of NHL patients.
流行病学研究表明,适量饮酒者的全因死亡率较低。饮酒也与降低非霍奇金淋巴瘤(NHL)的风险有关。在这里,我们通过所消耗的酒精类型和 NHL 亚型来研究酒精消耗对 NHL 生存的作用。
康涅狄格州在 1996-2000 年间诊断出的 575 名女性 NHL 发病病例组成了队列,随访中位数为 7.75 年。在诊断时收集了人口统计学、临床和生活方式信息。使用 Kaplan-Meier 方法进行生存分析,并使用 Cox 比例风险模型估计危险比(HR)。
与从不饮酒者相比,葡萄酒饮用者的总生存率更好(5 年生存率分别为 75%和 69%,对数秩检验 p 值=0.030),无病生存率更好(5 年无病生存率分别为 70%和 67%,对数秩检验 p 值=0.049)。通过 NHL 亚型分析表明,葡萄酒消耗的有利影响主要见于诊断为弥漫性大 B 细胞淋巴瘤(DLBCL)的患者(葡萄酒饮用者超过 25 年与从不饮酒者相比:总生存率的 HR=0.36,95%CI 0.14-0.94;无病生存率的 HR=0.38,95%CI 0.16-0.94),并且在 DLBCL 患者中也观察到了白酒消耗的不利影响(白酒饮用者与从不饮酒者相比:无病生存率的 HR=2.49,95%CI 1.26-4.93)。
我们的结果表明,在 NHL 患者中,诊断前饮酒与 NHL 生存之间存在适度的关系,特别是对 DLBCL 而言。这些结果需要在更大的研究中得到复制。
诊断前的行为可能会影响 NHL 患者的预后和生存。