Purpose: To explore the effect of alcohol on the inflammatory status and prognosis of patients with malignancy.
Patients and Methods: The clinical data of patients with malignant tumor who were admitted to the First Hospital of Jilin University from November 2011 to December 2018 were collected including basic clinical information, anthropometric indicators, body composition analysis, and serological indicators. Univariate and multivariate Cox proportional hazards models were performed to find predictors of survival. A nomogram was generated to indicate the interrelationships between the variables in the prediction model and the extent to which alcohol consumption affects prognosis. The C-index and calibration curves were used to verify the predictive accuracy of the scoring system.
Results: A total of 2929 cancer patients were included in this study, of which 552 (18.8%) patients had alcohol consumption habits and 2377 (81.2%) patients had no alcohol history. Patients in the Alcohol group had significantly shorter overall survival (OS) than the Non-Alcohol group, and further sub-analysis indicated alcohol consumption was significantly associated with prognosis of advanced breast cancer (HR = 4.617, 95% CI 1.361– 15.664, p=0.014), and early stage hepatocellular carcinoma (HCC) without viral hepatitis (HR = 8.933, 95% CI 1.444– 55.275, p = 0.019). Multivariate Cox regression models also demonstrated that daily alcohol intake was a risk factor of survival benefits (HR = 1.256, 95% CI 1.016– 1.554, p = 0.036). Finally, a nomogram was constructed and the c-index of this scoring system is 0.751. The 3- and 5-year calibration curves of the model show a high agreement between the predicted probability and the actual observed survival rate.
Conclusion: Alcohol intake was demonstrated associates with patient outcomes. A human component-prognosis scoring system was established to predict the survival benefits of cancer patients.
Keywords: alcohol, inflammation, cancer, prognosis