Yu-Ling Chang1,2, Yun-Fang Tsai3,4, Yin-Kai Chao5, Meng-Yu Wu6. 1. Department of Nursing, Chang Gung Memorial Hospital, Linkou, Tao-Yuan, Taiwan. 2. Graduate Institute of Clinical Medical Sciences, Chang Gung University, Tao-Yuan, Taiwan. 3. School of Nursing, College of Medicine, Chang Gung University, 259, Wen-Hwa 1st Road, Tao-Yuan, 333, Taiwan. yftsai@mail.cgu.edu.tw. 4. Department of Nursing, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan. yftsai@mail.cgu.edu.tw. 5. Department of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan. 6. Department of Cardiovascular Surgery, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan.
Abstract
PURPOSE: Improving survival after esophagectomy is an important issue in treating patients with esophageal cancer (EC). In addition to standard hospitalization management, periodic assessment of quality-of-life (QOL) measures may be useful to detect disease progression from patients' subjective reports. Therefore, this prospective longitudinal study was undertaken to identify prognostic factors for 3-year survival of EC patients after esophagectomy and to evaluate the impact of QOL measures on these prognostic factors. METHODS: Patients with EC (n = 67) who had a complete tumor resection and were alive 6 months after esophagectomy were followed in this study for 3 years. Data were collected on patients' sociodemographics, cancer characteristics, adjuvant therapy, general QOL and EC-specific QOL (before esophagectomy and 6 months afterward), cancer recurrence, and death. Patients' independent risk factors for 3-year survival were investigated by multivariate Cox regression analysis. RESULTS: Of the 67 participants with EC, 26 had late mortality, with a median survival for the whole cohort of 38.2 months (95 % CI 31.97-44.35). Independent predictors of early death were early cancer recurrence (within 6 months after surgery), poor cognitive function (95 % CI 1.020-1.041), and worse dyspnea (95 % CI 1.007-1.034). CONCLUSIONS: The most predictive factor for early death in EC patients after esophagectomy was cancer recurrence within 6 months after surgery. However, QOL measures could be a tool to provide clinical information from patients' perspective suggesting cancer recurrence.
PURPOSE: Improving survival after esophagectomy is an important issue in treating patients with esophageal cancer (EC). In addition to standard hospitalization management, periodic assessment of quality-of-life (QOL) measures may be useful to detect disease progression from patients' subjective reports. Therefore, this prospective longitudinal study was undertaken to identify prognostic factors for 3-year survival of EC patients after esophagectomy and to evaluate the impact of QOL measures on these prognostic factors. METHODS:Patients with EC (n = 67) who had a complete tumor resection and were alive 6 months after esophagectomy were followed in this study for 3 years. Data were collected on patients' sociodemographics, cancer characteristics, adjuvant therapy, general QOL and EC-specific QOL (before esophagectomy and 6 months afterward), cancer recurrence, and death. Patients' independent risk factors for 3-year survival were investigated by multivariate Cox regression analysis. RESULTS: Of the 67 participants with EC, 26 had late mortality, with a median survival for the whole cohort of 38.2 months (95 % CI 31.97-44.35). Independent predictors of early death were early cancer recurrence (within 6 months after surgery), poor cognitive function (95 % CI 1.020-1.041), and worse dyspnea (95 % CI 1.007-1.034). CONCLUSIONS: The most predictive factor for early death in EC patients after esophagectomy was cancer recurrence within 6 months after surgery. However, QOL measures could be a tool to provide clinical information from patients' perspective suggesting cancer recurrence.
Entities:
Keywords:
Cancer recurrence; Esophageal cancer; Esophagectomy; QOL; Survival
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