Sheraz R Markar1,2, Giovanni Zaninotto1, Carlo Castoro3,4, Asif Johar2, Pernilla Lagergren1,2, Jessie A Elliott5, Suzanne S Gisbertz6, Christophe Mariette7, Rita Alfieri3, Jeremy Huddy1, Viknesh Sounderajah1, Eleonora Pinto3, Marco Scarpa3, Fredrik Klevebro2, Berit Sunde2, Conor F Murphy5, Christine Greene5, Narayanasamy Ravi5, Guillaume Piessen7, Hylke Brenkman8, Jelle P Ruurda8, Richard Van Hillegersberg8, Sjoerd Lagarde9, Bas Wijnhoven9, Manuel Pera10, José Roig10, Sandra Castro10, Robert Matthijsen11, John Findlay12, Stefan Antonowicz12, Nick Maynard12, Orla McCormack13, Arun Ariyarathenam14, Grant Sanders14, Edward Cheong15, Shameen Jaunoo16, William Allum13, Jan Van Lanschot9, Magnus Nilsson17, John V Reynolds5, Mark I van Berge Henegouwen6, George B Hanna1. 1. Department Surgery and Cancer, Imperial College London, UK. 2. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. 3. Unit of Surgical Oncology of the Esophagus and Digestive Tract, Veneto Institute of Oncology, Padova, Italy. 4. Division of Upper Gastrointestinal Surgery, Department of Surgery, Humanitas Research Hospital IRCCS, Humanitas University, Rozzano, Milan, Italy. 5. Department of Surgery, Trinity Centre for Health Sciences, St. James's Hospital and Trinity College Dublin, Dublin, Ireland. 6. Department of Surgery, Amsterdam UMC, location AMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, the Netherlands. 7. University Lille, Department of Digestive and Oncological Surgery, Claude Huriez University Hospital, Lille, France. 8. Department of Surgery, University Medical Center Utrecht, Utrecht, the Netherlands. 9. Department of Surgery, Erasmus MC, University Medical Center, Rotterdam, the Netherlands. 10. Department of Surgery, University Hospital del Mar, Barcelona, Spain. 11. Department of Gastrointestinal Surgery, ETZ Tilburg, the Netherlands. 12. Department of Upper GI Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. 13. Academic Department of Surgery, Royal Marsden Hospital, London, UK. 14. Department of Oesophago-Gastric Surgery, Plymouth Hospitals NHS Trust, Plymouth, UK. 15. Department of Upper Gastrointestinal Surgery, Norfolk & Norwich Hospitals NHS Trust, Norwich, UK. 16. Department of Upper Gastrointestinal Surgery, Gloucestershire Hospitals NHS Foundation Trust, Gloucestershire, UK. 17. Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm, Sweden.
Abstract
OBJECTIVE: To identify the most prevalent symptoms and those with greatest impact upon health-related quality of life (HRQOL) among esophageal cancer survivors. BACKGROUND: Long-term symptom burden after esophagectomy, and associations with HRQOL, are poorly understood. PATIENTS AND METHODS: Between 2010 and 2016, patients from 20 European Centers who underwent esophageal cancer surgery, and were disease-free at least 1 year postoperatively were asked to complete LASER, EORTC-QLQ-C30, and QLQ-OG25 questionnaires. Specific symptom questionnaire items that were associated with poor HRQOL as identified by EORTC QLQ-C30 and QLQ-OG25 were identified by multivariable regression analysis and combined to form a tool. RESULTS: A total of 876 of 1081 invited patients responded to the questionnaire, giving a response rate of 81%. Of these, 66.9% stated in the last 6 months they had symptoms associated with their esophagectomy. Ongoing weight loss was reported by 10.4% of patients, and only 13.8% returned to work with the same activities.Three LASER symptoms were correlated with poor HRQOL on multivariable analysis; pain on scars on chest (odds ratio (OR) 1.27; 95% CI 0.97-1.65), low mood (OR 1.42; 95% CI 1.15-1.77) and reduced energy or activity tolerance (OR 1.37; 95% CI 1.18-1.59). The areas under the curves for the development and validation datasets were 0.81 ± 0.02 and 0.82 ± 0.09 respectively. CONCLUSION: Two-thirds of patients experience significant symptoms more than 1 year after surgery. The 3 key symptoms associated with poor HRQOL identified in this study should be further validated, and could be used in clinical practice to identify patients who require increased support.
OBJECTIVE: To identify the most prevalent symptoms and those with greatest impact upon health-related quality of life (HRQOL) among esophageal cancer survivors. BACKGROUND: Long-term symptom burden after esophagectomy, and associations with HRQOL, are poorly understood. PATIENTS AND METHODS: Between 2010 and 2016, patients from 20 European Centers who underwent esophageal cancer surgery, and were disease-free at least 1 year postoperatively were asked to complete LASER, EORTC-QLQ-C30, and QLQ-OG25 questionnaires. Specific symptom questionnaire items that were associated with poor HRQOL as identified by EORTC QLQ-C30 and QLQ-OG25 were identified by multivariable regression analysis and combined to form a tool. RESULTS: A total of 876 of 1081 invited patients responded to the questionnaire, giving a response rate of 81%. Of these, 66.9% stated in the last 6 months they had symptoms associated with their esophagectomy. Ongoing weight loss was reported by 10.4% of patients, and only 13.8% returned to work with the same activities.Three LASER symptoms were correlated with poor HRQOL on multivariable analysis; pain on scars on chest (odds ratio (OR) 1.27; 95% CI 0.97-1.65), low mood (OR 1.42; 95% CI 1.15-1.77) and reduced energy or activity tolerance (OR 1.37; 95% CI 1.18-1.59). The areas under the curves for the development and validation datasets were 0.81 ± 0.02 and 0.82 ± 0.09 respectively. CONCLUSION: Two-thirds of patients experience significant symptoms more than 1 year after surgery. The 3 key symptoms associated with poor HRQOL identified in this study should be further validated, and could be used in clinical practice to identify patients who require increased support.
Authors: Eleonora Pinto; Alessandro Fabbian; Rita Alfieri; Anna Da Roit; Salvatore Marano; Genny Mattara; Pierluigi Pilati; Carlo Castoro; Marco Cavarzan; Marta Silvia Dalla Riva; Luisa Orrù; Gian Piero Turchi Journal: Behav Sci (Basel) Date: 2022-04-09
Authors: Karina H Tukanova; Swathikan Chidambaram; Nadia Guidozzi; George B Hanna; Alison H McGregor; Sheraz R Markar Journal: Ann Surg Oncol Date: 2021-12-27 Impact factor: 5.344
Authors: Philip H Pucher; Annie Coombes; Orla Evans; Joanna Taylor; Jonathan L Moore; Annabelle White; Jesper Lagergren; Cara Baker; Mark Kelly; James A Gossage; Jason Dunn; Sebastian Zeki; Ben E Byrne; Jervoise Andreyev; Andrew R Davies Journal: Support Care Cancer Date: 2022-03-11 Impact factor: 3.359