Anna Schandl1,2,3, Zhao Cheng4, Asif Johar4, Pernilla Lagergren4,5. 1. Surgical Care Science, Department of Molecular Medicine and Surgery, Karolinska Institutet, Retzius väg 13A, 4th floor, 171 77, Stockholm, Sweden. anna.schandl@ki.se. 2. Department of Anaesthesia and Intensive Care, 118 83 Stockholm, Södersjukhuset, Sweden. anna.schandl@ki.se. 3. Department of Clinical Science and Education, 118 83 Stockholm, Södersjukhuset, Karolinska Institutet, Sweden. anna.schandl@ki.se. 4. Surgical Care Science, Department of Molecular Medicine and Surgery, Karolinska Institutet, Retzius väg 13A, 4th floor, 171 77, Stockholm, Sweden. 5. Department of Surgery & Cancer, Imperial College London, London, UK.
Abstract
PURPOSE: We aimed to study oesophageal cancer survivors' health-related quality of life (HRQL) 15 years after surgery and to identify factors related to reduced HRQL. METHODS: A nationwide, prospective cohort study enrolling 616 patients who underwent open oesophageal cancer surgery in Sweden between April 2, 2001, and December 21, 2005. HRQL was evaluated by questionnaires 15 years after surgery. HRQL data for the 15-year survivors were individually matched for age, sex and comorbidity by using values from a Swedish background population. Multivariable linear regression models provided mean score differences (MSD) with 95% confidence intervals (CI) for each HRQL scale and item. RESULTS: Among the 616 individuals in the original study group, 70 (11%) survived for 15 years and 52 (74%) responded to the questionnaires. Compared with a matched background population, the survivors reported problems in 10 of 25 HRQL aspects. Most of these were related to symptoms of the digestive tract, such as reflux (MSD 26.4, 95%CI: 18.3 to 34.4), dysphagia (MSD 17.7, 95%CI: 10.0 to 25.4) and eating difficulties (MSD 16.4, 95%CI: 11.3 to 21.4). Major postoperative complications after surgery were related to worse HRQL in 11 of 25 aspects. CONCLUSIONS: This study suggests that surgery for oesophageal cancer entails long-term, possibly life-long, symptoms related to the digestive tract. IMPLICATION FOR CANCER SURVIVORS: Comprehensive support from healthcare may be imperative for oesophageal cancer survivors to adapt to and cope with consequences of oesophageal cancer surgery. Prevention, early identification and adequate treatment of postoperative complications may improve patient outcome.
PURPOSE: We aimed to study oesophageal cancer survivors' health-related quality of life (HRQL) 15 years after surgery and to identify factors related to reduced HRQL. METHODS: A nationwide, prospective cohort study enrolling 616 patients who underwent open oesophageal cancer surgery in Sweden between April 2, 2001, and December 21, 2005. HRQL was evaluated by questionnaires 15 years after surgery. HRQL data for the 15-year survivors were individually matched for age, sex and comorbidity by using values from a Swedish background population. Multivariable linear regression models provided mean score differences (MSD) with 95% confidence intervals (CI) for each HRQL scale and item. RESULTS: Among the 616 individuals in the original study group, 70 (11%) survived for 15 years and 52 (74%) responded to the questionnaires. Compared with a matched background population, the survivors reported problems in 10 of 25 HRQL aspects. Most of these were related to symptoms of the digestive tract, such as reflux (MSD 26.4, 95%CI: 18.3 to 34.4), dysphagia (MSD 17.7, 95%CI: 10.0 to 25.4) and eating difficulties (MSD 16.4, 95%CI: 11.3 to 21.4). Major postoperative complications after surgery were related to worse HRQL in 11 of 25 aspects. CONCLUSIONS: This study suggests that surgery for oesophageal cancer entails long-term, possibly life-long, symptoms related to the digestive tract. IMPLICATION FOR CANCER SURVIVORS: Comprehensive support from healthcare may be imperative for oesophageal cancer survivors to adapt to and cope with consequences of oesophageal cancer surgery. Prevention, early identification and adequate treatment of postoperative complications may improve patient outcome.
Authors: Donald E Low; Madhan Kumar Kuppusamy; Derek Alderson; Ivan Cecconello; Andrew C Chang; Gail Darling; Andrew Davies; Xavier Benoit D'Journo; Suzanne S Gisbertz; S Michael Griffin; Richard Hardwick; Arnulf Hoelscher; Wayne Hofstetter; Blair Jobe; Yuko Kitagawa; Simon Law; Christophe Mariette; Nick Maynard; Christopher R Morse; Philippe Nafteux; Manuel Pera; C S Pramesh; Sonia Puig; John V Reynolds; Wolfgang Schroeder; Mark Smithers; B P L Wijnhoven Journal: Ann Surg Date: 2019-02 Impact factor: 12.969
Authors: Héctor G van den Boorn; Charlotte I Stroes; Aeilko H Zwinderman; Wietse J Eshuis; Maarten C C M Hulshof; Faridi S van Etten-Jamaludin; Mirjam A G Sprangers; Hanneke W M van Laarhoven Journal: Crit Rev Oncol Hematol Date: 2020-08-05 Impact factor: 6.312
Authors: Alberto Ruol; Carlo Castoro; Giuseppe Portale; Francesco Cavallin; Vanna Chiarion Sileni; Matteo Cagol; Rita Alfieri; Luigi Corti; Caterina Boso; Giovanni Zaninotto; Alberto Peracchia; Ermanno Ancona Journal: Arch Surg Date: 2009-03
Authors: M Jacobs; R C Macefield; R G Elbers; K Sitnikova; I J Korfage; E M A Smets; I Henselmans; M I van Berge Henegouwen; J C J M de Haes; J M Blazeby; M A G Sprangers Journal: Qual Life Res Date: 2013-12-03 Impact factor: 4.147