Top

World Journal of Surgery

Published in:

01-08-2011

Long-Term Health-Related Quality of Life for Disease-Free Esophageal Cancer Patients

Authors: Claire L. Donohoe, Erin McGillycuddy, John V. Reynolds

Published in: World Journal of Surgery | Issue 8/2011

Abstract

Background

Health-related quality of life (HRQL) has been studied extensively during the first year following esophagectomy, but little is known about HRQL in long-term survivors. The aim of this study was to investigate HRQL in patients alive at least 1 year after surgical resection for esophageal cancer using validated European Organisation for Research and Treatment of Cancer (EORTC) quality of life (QOL) questionnaires (QLQ).

Methods

Eligible patients, without known disease recurrence and at least 1 year after esophagectomy, were identified from a prospectively maintained database. Patients completed general (QLQ-C30) and esophageal cancer-specific (QLQ-OES18, OG25) questionnaires. A numeric score (0–100) was computed in each conceptual area and compared with validated cancer (n = 1031) and age-matched (n = 7802) healthy populations using two-tailed unpaired t-tests. A cohort of 80 patients had pretreatment scores recorded.

Results

Altogether, 132 of 156 eligible patients (84%) completed the self-rated questionnaire, 105 (67.3%) were men, and the mean age was 62 years (range 29–84 years). The mean time since esophagectomy was 70.3 months (12–299 months). Global health status was significantly reduced at least 1 year after esophagectomy (mean ± SD score 48.4 ± 18.6) when compared with patients with esophageal cancer prior to treatment (55.6 ± 24.1) and the general population (71.2 ± 22.4) (p < 0.0001). In a prospective cohort of eighty patients, symptoms related to swallowing difficulty, reflux, pain, and coughing significantly decreased in the long term (p < 0.0001). The degree of subjective swallowing dysfunction was highly correlated with a poor QOL (Spearman’s ρ = 0.508, p < 0.01).

Conclusions

Global health status remains significantly reduced in long-term survivors after esophagectomy compared with population controls, and swallowing dysfunction is highly associated with this compromised QOL.

Reynolds JV, McLaughlin R, Moore J et al (2006) Prospective evaluation of quality of life in patients with localized oesophageal cancer treated by multimodality therapy or surgery alone. Br J Surg 93:1084–1090PubMedCrossRef

Djarv T, Metcalfe C, Avery KN et al (2010) Prognostic value of changes in health-related quality of life scores during curative treatment for esophagogastric cancer. J Clin Oncol 28:1666–1670PubMedCrossRef

Blazeby JM, Farndon JR, Donovan J et al (2000) A prospective longitudinal study examining the quality of life of patients with esophageal carcinoma. Cancer 88:1781–1787PubMedCrossRef

Blazeby JM, Sanford E, Falk SJ et al (2005) Health-related quality of life during neoadjuvant treatment and surgery for localized esophageal carcinoma. Cancer 103:1791–1799PubMedCrossRef

Lagergren P, Avery KN, Hughes R et al (2007) Health-related quality of life among patients cured by surgery for esophageal cancer. Cancer 110:686–693PubMedCrossRef

De Boer AG, Genovesi PI, Sprangers MA et al (2000) Quality of life in long-term survivors after curative transhiatal oesophagectomy for oesophageal carcinoma. Br J Surg 87:1716–1721PubMedCrossRef

Rice T, Blackstone E, Rusch V (2010) 7th Edition of the AJCC Cancer Staging Manual: esophagus and esophagogastric junction. Ann Surg Oncol 17:1721–1724PubMedCrossRef

Siewert JR, Stein HJ (1998) Classification of adenocarcinoma of the oesophagogastric junction. Br J Surg 85:1457–1459PubMedCrossRef

Rüdiger Siewert J, Feith M, Werner M et al (2000) Adenocarcinoma of the esophagogastric junction: results of surgical therapy based on anatomical/topographic classification in 1,002 consecutive patients. Ann Surg 232:353–361PubMedCrossRef

10.

Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213PubMedCrossRef

11.

Aaronson NK, Ahmedzai S, Bergman B et al (1993) A quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376PubMedCrossRef

12.

Blazeby JM, Alderson D, Winstone K et al (1996) Development of an EORTC questionnaire module to be used in quality of life assessment for patients with oesophageal cancer. Eur J Cancer 32:1912–1917CrossRef

13.

Blazeby JM, Kavadas V, Vickery CW et al (2005) A prospective comparison of quality of life measures for patients with esophageal cancer. Qual Life Res 14:387–393PubMedCrossRef

14.

Clifton JC, Finley RJ, Gelfand G et al (2007) Development and validation of a disease-specific quality of life questionnaire (EQOL) for potentially curable patients with carcinoma of the esophagus. Dis Esophagus 20:191–201PubMedCrossRef

15.

Blazeby JM, Conroy T, Hammerlid E et al (2003) Clinical and psychometric validation of an EORTC questionnaire module, the EORTC QLQ-OES18, to assess quality of life in patients with oesophageal cancer. Eur J Cancer 39:1384–1394PubMedCrossRef

16.

Fayers PM, Aaronson NK, Bjordal K et al (2001) The EORTC QLQ-C30 Scoring Manual, 3rd edn. European Organisation for Research and Treatment of Cancer, Brussels

17.

Martin L, Lagergren P (2009) Long-term weight change after oesophageal cancer surgery. Br J Surg 96:1308–1314PubMedCrossRef

18.

Young MM, Deschamps C, Allen MS et al (2000) Esophageal reconstruction for benign disease: self-assessment of functional outcome and quality of life. Ann Thorac Surg 70:1799–1802PubMedCrossRef

19.

Gockel I, Gönner U, Domeyer M et al (2010) Long-term survivors of esophageal cancer: disease-specific quality of life, general health and complications. J Surg Oncol 102:516–522PubMedCrossRef

20.

Aghajanzadeh M, Safarpour F, Koohsari MR et al (2009) Functional outcome of gastrointestinal tract and quality of life after esophageal reconstruction of esophagus cancer. Saudi J Gastroenterol 15:24–28PubMedCrossRef

21.

McLarty AJ, Deschamps C, Trastek VF et al (1997) Esophageal resection for cancer of the esophagus: long-term function and quality of life. Ann Thorac Surg 63:1568–1572PubMedCrossRef

22.

Zieren HU, Jacobi CA, Zieren J et al (1996) Quality of life following resection of oesophageal carcinoma. Br J Surg 83:1772–1775PubMedCrossRef

23.

Lee HS, Kim MS, Lee JM et al (2005) Intrathoracic gastric emptying of solid food after esophagectomy for esophageal cancer. Ann Thorac Surg 80:443–447PubMedCrossRef

24.

D’Journo XB, Martin J, Rakovich G et al (2009) Mucosal damage in the esophageal remnant after esophagectomy and gastric transposition. Ann Surg 249:262–268PubMedCrossRef

25.

Kauer WK, Stein HJ, Bartels H et al (2003) Intratracheal long-term pH monitoring: a new method to evaluate episodes of silent acid aspiration in patients after esophagectomy and gastric pull up. J Gastrointest Surg 7:599–602PubMedCrossRef

26.

O’Riordan JM, Tucker ON, Byrne PJ et al (2004) Factors influencing the development of Barrett’s epithelium in the esophageal remnant postesophagectomy. Am J Gastroenterol 99:205–211PubMedCrossRef

27.

Johansson J, Oberg S, Wenner J et al (2009) Impact of proton pump inhibitors on benign anastomotic stricture formations after esophagectomy and gastric tube reconstruction: results from a randomized clinical trial. Ann Surg 250:667–673PubMedCrossRef

28.

Banki F, Mason RJ, DeMeester SR et al (2002) Vagal-sparing esophagectomy: a more physiologic alternative. Ann Surg 236:324–335 discussion 335–336PubMedCrossRef

29.

Peyre CG, DeMeester SR, Rizzetto C et al (2007) Vagal-sparing esophagectomy: the ideal operation for intramucosal adenocarcinoma and Barrett with high-grade dysplasia. Ann Surg 246:665–671 discussion 671–674PubMedCrossRef

30.

Luketich JD, Alvelo-Rivera M, Buenaventura PO et al (2003) Minimally invasive esophagectomy: outcomes in 222 patients. Ann Surg 238:486–494 discussion 494–495PubMed

31.

Parameswaran R, Blazeby JM, Hughes R et al (2010) Health-related quality of life after minimally invasive oesophagectomy. Br J Surg 97:525–531PubMedCrossRef

32.

Stiller CA (1994) Centralised treatment, entry to trials and survival. Br J Cancer 70:352–362PubMedCrossRef

Title: Long-Term Health-Related Quality of Life for Disease-Free Esophageal Cancer Patients
Authors: Claire L. Donohoe
Erin McGillycuddy
John V. Reynolds
Publication date: 01-08-2011
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 8/2011
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-011-1123-6

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Long-Term Health-Related Quality of Life for Disease-Free Esophageal Cancer Patients

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 8/2011

Laparoscopic Simple Closure Alone is Adequate for Low Risk Patients with Perforated Peptic Ulcer

Roles and Mechanisms of MicroRNAs in Pancreatic Cancer

Genotyping Gastric Cancer

The Hypofunctional Effect of P335L Single Nucleotide Polymorphism on SSTR5 Function

Proof-of-Concept Study on the Endoscopic Minimally Invasive Thyroidectomy (eMIT) in Humans: A Realistic Assessment is Desired: Reply

Risk Factors for Persistent Anal Incontinence After Restorative Proctectomy in Rectal Cancer Patients with Anal Incontinence: Prospective Cohort Study