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Nutrition and Health (including climate and ecological aspects)

Effect of dietary consumption on the survival of esophageal squamous cell carcinoma: a prospective cohort study



This prospective cohort study was to assess the association of pre-diagnostic dietary intake and dietary pattern with the survival of esophageal squamous cell carcinoma (ESCC) patients.


855 patients were recruited and successfully followed. Information on diet over past five years before diagnosis was collected using a food frequency questionnaire, and dietary patterns were extracted using principal component analysis. Hazard ratio (HR) with 95% confidence interval (95% CI) was calculated using the Cox proportional hazard model.


164 (19.18%) ESCC patients survived during the follow-up. Every 25-g increment intake of pickled vegetables was associated with a 6.0% (HR: 1.060, 95% CI: 1.003–1.121) increased risk of death after adjustment for covariates. When comparing the highest with lowest tertiles of energy-adjusted intake, pickled vegetables intake was associated with a 21.9% elevated risk of death (HR: 1.219, 95% CI: 1.014–1.465), while fish and shrimp intake was associated with a 19.4% (HR: 0.816, 95% CI: 0.675–0.986) reduced risk of death. Three dietary patterns were defined and labeled as patterns I, II, and III. Every 10-score increment of dietary pattern II, characterized with a higher loading of preserved vegetables, pickled vegetables, and salted meat, was associated with a 1.7% (HR: 1.017, 95% CI: 1.003–1.032) increased risk of death.


A diet characterized with higher loading of preserved vegetables, pickled vegetables, and salted meat, was negatively associated with death risk among ESCC patients. Prospective studies concerning the role of post-diagnosis dietary intake in ESCC prognosis are needed.

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Data availability

The data used to support the findings of this study are available from the corresponding author upon request and a detailed protocol should be provided.


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The authors would like to thank epidemiologists, nurses, and doctors in the Yanting Tumor Hospital, Yanting Center for Disease Control and Prevention, and the community-based health service centers for their cooperation in data collection, and thank all study subjects for their participation.


The study was supported by the Guangdong Basic and Applied Basic Research Foundation (Nos. 2019A1515011599, 2022A1515010686), the Science and Technology Program of Guangzhou City (No.202102080404), the National Key R&D Program of China (No. 2018YFE0208000). The founder had no role in the design, analysis, or writing of this manuscript.

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Authors and Affiliations



XDL conceived and designed the study; YZ analyzed the data; JL, LL, SHL, XDL collected the data; YZ and WJZ drafted the manuscript; ZFR, JL, JHL, SHL, XBX, and XDL reviewed and edited the manuscript. All co-authors provided comments and approved the final version.

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Correspondence to Xudong Liu.

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The authors declare no competing interests.

Ethics approval and consent to participate

The study was approved Ethical Review Committee for Biomedical Research, School of Public Health, Sun Yat-sen University (No. 2019-096). It met the requirements of the Declaration of Helsinki and Informed consent was obtained from all subjects involved in the study. Patients and/or the public were not involved in the design, conduct, reporting, or dissemination plans of this research.

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Zhao, Y., Zhao, W., Li, J. et al. Effect of dietary consumption on the survival of esophageal squamous cell carcinoma: a prospective cohort study. Eur J Clin Nutr (2022).

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