Health-Related Quality of Life in Patients with Oesophageal Cancer: Analysis at Different Steps of the Treatment Pathway

Scarpa, Marco; Saadeh, Luca Maria; Fasolo, A.; Alfieri, Rita; Cagol, Matteo; Cavallin, Francesco; Pinto, Eleonora; Zaninotto, Giovanni; Ancona, Ermanno; Castoro, Carlo

doi:10.1007/s11605-012-2069-1

Cited by 63 publications

(54 citation statements)

References 38 publications

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“…In fact, apart from the risk of severe postoperative complications, postoperative pain, fatigue, and sleep disturbances can heavily affect a patient’s postoperative quality of life [8]. Following esophagectomy, sleep disruption can occur because of painful stimuli [9], constant discomfort caused by the nasogastric tube [10], and the constant noise and light in the ICU.…”

Section: Discussionmentioning

confidence: 99%

“…In fact, the risk of severe postoperative complications is high even in specialized centers [6]; moreover, postoperative pain can heavily affect postoperative quality of life [8]. Sleep disruption by painful stimuli is frequently observed both in clinical and experimental conditions [9].…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, we observed that postoperative pain, and its relief, are the main predictors of early postoperative quality of life after esophagectomy [8]. Therefore, the aims of this prospective study were to analyze the predictors of postoperative sleep disturbance after esophagectomy for cancer and to identify patients at risk for postoperative hypnotic administration.…”

Section: Introductionmentioning

confidence: 99%

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Sleep disturbances and quality of life in postoperative management after esophagectomy for esophageal cancer

et al. 2014

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BackgroundThe aims of this prospective study were to analyze the predictors of postoperative sleep disturbance after esophagectomy for cancer and to identify patients at risk for postoperative hypnotic administration.MethodsSixty two consecutive patients who underwent cancer-related esophagectomy were enrolled in this study from May 2011 to February 2012. Data about perioperative management, postoperative complications, ICU stay, and vasopressor, hypnotic, and painkiller administration were retrieved. The EORTC QLQ-C30 was used and global quality of life (QL2 item) and sleep disturbance (SL item) were the primary endpoints. Univariate and multivariate analyses were performed.ResultsPostoperative request of hypnotics independently predicted bad quality of life outcome. Sleep disturbance after esophagectomy was independently predicted by the duration of dopamine infusion in the ICU and the daily request of benzodiazepines. Even in this case, only sleep disturbance at diagnosis revealed to be an independent predictor of hypnotic administration need. ROC curve analysis showed that sleep disturbance at diagnosis was a good predictor of benzodiazepine request (AUC = 73%, P = 0.02).ConclusionsThe use of vasopressors in the ICU affects sleep in the following postoperative period and the use of hypnotics is neither completely successful nor lacking in possible consequences. Sleep disturbance at diagnosis can successfully predict patients who can develop sleep disturbance during the postoperative period.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Sleep disturbances and quality of life in postoperative management after esophagectomy for esophageal cancer

et al. 2014

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“…Additionally, existing studies on the symptom clusters of oesophageal cancer mostly focus on patients who had also received chemoradiotherapy (Liu et al, ), while few studies were performed on patients after surgery. Longitudinal studies revealed that the observed postoperative increase in symptoms and deterioration in function is mostly alleviated within 6–12 months after surgery (Gutschow et al, ; Scarpa et al, ). However, 3 months after surgery, despite the gradual decline in acute treatment‐related symptoms, the patient has not yet recovered to the preoperative state.…”

Section: Introductionmentioning

confidence: 99%

Symptom clusters and related factors in oesophageal cancer patients 3 months after surgery

Guo

Wang

Yin

et al. 2019

Journal of Clinical Nursing

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Aim To explore symptom clusters experienced by patients with oesophageal cancer 3 months after surgery and examine whether symptom clusters are related to demographic, clinical and quality of life variables. Background There are multiple symptoms in patients with oesophageal cancer after surgery, which seriously affect their quality of life. Exploring the mechanics of concurrent symptoms such as symptom clusters may facilitate the development of strategies to reduce the impact of these symptoms and improve quality of life. Design Cross‐sectional survey. The STROBE Statement was chosen as the EQUATOR checklist. Methods A convenience sample of 128 oesophageal cancer patients was followed up at 3 months after surgery. Participants completed the demographic questionnaire, the M. D. Anderson Symptom Inventory for Gastrointestinal Cancer, the Functional Assessment of Cancer Therapy‐General and the Connor‐Davidson Resilience Scale. Exploratory factor analysis, stepwise regression and correlation analysis were applied. Results Four symptom clusters were identified: dysphagia–psychological, chemoradiotherapy side‐effect, digestive tract reconstruction and fatigue–sleep. Gender, stage of disease and resilience influenced the dysphagia–psychological symptom cluster. Gender, stage of disease, resilience and treatment were significant factors affecting the chemoradiotherapy side‐effect and fatigue–sleep symptom clusters. Gender, stage of disease, resilience and anastomotic position were significant factors influencing the digestive tract reconstruction symptom cluster. The correlations between symptom clusters and quality of life were significant, with the highest correlation between the dysphagia–psychological cluster and quality of life. Conclusions Nurses should pay more attention to symptom management in patients with oesophageal cancer 3 months after surgery by focusing on four symptom clusters. It is necessary to implement individualised care depending on the influence factors including gender, stage of disease, resilience, treatment and anastomotic position. Relevance to clinical practice These findings will help develop targeted interventions to facilitate further symptom management for transitional nursing from the peri‐operative phase to long‐term rehabilitation.

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“…Retrospective studies have reported improved survival for treatment that includes surgery, but these studies are obviously limited by selection bias (36). Even if esophagectomy offers some survival benefit, that benefit must be weighed against the potential short-term and longterm harms, including perioperative mortality and morbidity, and adverse effects on long-term quality of life (37).…”

Section: Definitive Crtmentioning

confidence: 99%

Surveillance or resection after chemoradiation in esophageal cancer

Park

Kim

2018

Ann. Transl. Med.

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The treatment of locally advanced esophageal cancer continues to evolve. Previously, surgery was considered the foundation of treatment, but chemoradiation (CRT) has taken on a larger role both in the neoadjuvant setting and as definitive treatment. It has become clear that although some patients benefit from esophagectomy after CRT, a large subset of patients likely derive no benefit, and may be harmed by surgery.Some patients are cured from CRT alone and therefore do not need surgery. Another group of patients likely have metastatic disease at the time of local therapy that is just undetected on imaging and also do not benefit from surgery. A third group of patients will have persistent locoregional disease only after CRT. This last group is the subset who will actually benefit from surgery, but this likely comprises only a minority of patients with locally advanced disease. A strategy to maximize survival while minimizing unnecessary surgery is a reasonable goal, but present technology does not allow us to do this with certainty. Thus, the decision of whether to pursue resection or surveillance after CRT can be difficult as clinicians and patients try to balance the goal of maximizing the likelihood of cure against the risk of surgery and its impact on quality of life.

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Health-Related Quality of Life in Patients with Oesophageal Cancer: Analysis at Different Steps of the Treatment Pathway

Cited by 63 publications

References 38 publications

Sleep disturbances and quality of life in postoperative management after esophagectomy for esophageal cancer

Sleep disturbances and quality of life in postoperative management after esophagectomy for esophageal cancer

Symptom clusters and related factors in oesophageal cancer patients 3 months after surgery

Surveillance or resection after chemoradiation in esophageal cancer

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