Psychological distress and health-related quality of life up to 2 years after oesophageal cancer surgery: nationwide population-based study

Liu, Yangjun; Schandl, Anna; Markar, Sheraz R.; Johar, Asif; Lagergren, Pernilla

doi:10.1093/bjsopen/zraa038

Cited by 17 publications

(17 citation statements)

References 41 publications

(8 reference statements)

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“…Data for the present study were drawn from a prospective, ongoing, Swedish nationwide, and population-based cohort study entitled Oesophageal Surgery on Cancer patients-Adaptation and Recovery (OSCAR). Details of the OSCAR study have been described elsewhere [26,27]. In brief, all 1-year survivors without cognitive impairment undergoing esophagectomy for cancer in Sweden from January 1, 2013, and onwards are invited (approximate response rate 66%) [26].…”

Section: Methodsmentioning

confidence: 99%

Dispositional optimism and all-cause mortality after esophageal cancer surgery: a nationwide population-based cohort study

Liu

Pettersson

Schandl

et al. 2022

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Purpose To examine the association between dispositional optimism and all-cause mortality after esophageal cancer surgery and whether pathological tumor stage and the COVID-19 pandemic modified this association. Methods This nationwide, population-based prospective cohort study included 335 patients undergoing esophageal cancer surgery in Sweden between January 1, 2013, and December 31, 2019. Dispositional optimism was measured 1 year post-surgery using Life Orientation Test-Revised (LOT-R). A higher LOT-R sum score represents higher dispositional optimism. Mortality information was obtained from the Swedish Register of the Total Population. All patients were followed up until death or until December 31, 2020, whichever occurred first. Cox regression with adjustments for confounders was used. Results The median follow-up was 20.8 months, during which 125 (37.3%) patients died. Among the included 335 patients, 219 (65.4%) patients had tumor pathologically staged Tis-II, and 300 (89.6%) patients entered the cohort before the COVID-19 pandemic. Both tumor stage and the COVID-19 pandemic were effect modifiers. For each unit increase in LOT-R sum score, the risk of all-cause mortality decreased by 11% (HR 0.89, 95% CI 0.81 to 0.98) among patients with tumor staged Tis-II before the COVID-19 pandemic. This association was non-significant in patients with tumor staged III–IV (HR 0.99, 95% CI 0.92 to 1.07) and during the COVID-19 pandemic (HR 1.08, 95% CI 0.94 to 1.25). Conclusion Assessing dispositional optimism may help predict postoperative survival, especially for patients with early and intermediate esophageal cancer. Increasing dispositional optimism might be a potential intervention target to improve survival after esophageal cancer surgery.

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Section: Methodsmentioning

confidence: 99%

Dispositional optimism and all-cause mortality after esophageal cancer surgery: a nationwide population-based cohort study

Liu

Pettersson

Schandl

et al. 2022

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“… 15 At two years post-oesophagectomy, eating difficulties and reluctance to eat in front of others has been associated with psychological distress. 23 In a recent cross-sectional cohort study on patient-reported outcomes post-oesophagectomy, long-term symptom burden is common in this patient group, with swallowing/conduit problems being one of the six main problems reported. 24 Ten years post-operatively, swallowing difficulties persist for half of survivors.…”

Section: Introductionmentioning

confidence: 93%

“…One-year post-oesophagectomy, almost half of survivors’ report eating restrictions and other symptoms include dry mouth, taste problems, difficulty swallowing saliva and choking 15. At two years post-oesophagectomy, eating difficulties and reluctance to eat in front of others has been associated with psychological distress 23. In a recent cross-sectional cohort study on patient-reported outcomes post-oesophagectomy, long-term symptom burden is common in this patient group, with swallowing/conduit problems being one of the six main problems reported 24.…”

Section: Introductionmentioning

confidence: 99%

Prevalence, nature and trajectory of dysphagia postoesophageal cancer surgery: a prospective longitudinal study protocol

et al. 2022

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IntroductionDysphagia is a common problem following oesophagectomy, and is associated with aspiration pneumonia, malnutrition, weight loss, prolonged enteral feeding tube dependence, in addition to an extended in-hospital stay and compromised quality of life (QOL). To date, the prevalence, nature and trajectory of post-oesophagectomy dysphagia has not been systematically studied in a prospective longitudinal design. The study aims (1) to evaluate the prevalence, nature and trajectory of dysphagia for participants undergoing an oesophagectomy as part of curative treatment, (2) to determine the risk factors for, and post-operative complications of dysphagia in this population and (3) to examine the impact of oropharyngeal dysphagia on health-related QOL across time points.Methods and analysisA videofluoroscopy will be completed and analysed on both post-operative day (POD) 4 or 5 and at 6-months post-surgery. Other swallow evaluations will be completed preoperatively, POD 4 or 5, 1-month and 6-month time points will include a swallowing screening test, tongue pressure measurement, cough reflex testing and an oral hygiene evaluation. Nutritional measurements will include the Functional Oral Intake Scale to measure feeding tube reliance, Malnutrition Screening Tool and the Strength, Assistance With Walking, Rise From a Chair, Climb Stairs and Falls questionnaire. The Reflux Symptom Index will be administered to investigate aerodigestive symptoms commonly experienced by adults post-oesophagectomy. Swallowing-related QOL outcome measures will be determined using the European Organisation for Research and Treatment of Cancer QLQ-18, MD Anderson Dysphagia Inventory and the Swallowing Quality of Life Questionnaire.Ethics and disseminationEthical approval has been granted by the Tallaght University Hospital/St. James’ Hospital Research Ethics Committee (JREC), Dublin, Ireland (Ref. No. 2021-Jul-310). The study results will be published in peer-reviewed journals and presented at national and international scientific conferences.

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“…These studies have highlighted that diagnosis and treatment are associated with signi cant and sustained levels of psychological morbidity (8,11). In oesophageal cancer patients, heightened levels of psychological distress have been associated with poorer health-related quality of life outcomes up to two years after surgery (12) and in gastric cancer patients, signi cantly higher incidence of depressive disorders have been identi ed compared to their healthy matched cohort (13). Whilst these studies have identi ed that surviving oesophago-gastric cancer and its subsequent treatment can have some adverse consequences for psychosocial functioning, there is wider evidence to suggest that palliative care needs increase and quality of life deteriorates once cancer advances beyond a curative state (14).…”

Section: Pre-registrationmentioning

confidence: 99%

Psychosocial functioning in individuals with advanced oesophago-gastric cancer: a mixed methods systematic review

Ghiglieri

Dempster

Wright

et al. 2022

Preprint

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Background Oesophago-gastric cancer is an aggressive disease with a high rate of recurrence and mortality across the disease trajectory. Reduced psychosocial functioning has been evidenced amongst those with advanced disease, however little is known about the contributing factors. Determining these factors is an important clinical consideration to inform assessment and intervention. This review aimed to synthesize the available evidence on the psychosocial functioning of individuals with advanced oesophago-gastric cancer and their carers. Methods A JBI mixed-methods systematic review. Four bibliographic databases, MEDLINE, Embase, PsycINFO, and CINAHL, were searched. Quantitative and qualitative studies were screened for inclusion and critically appraised for methodological quality. Both types of data were extracted using JBI tools for mixed-methods systematic reviews. A convergent segregated approach to synthesis and integration was used. The findings of the synthesis have been configured according to JBI methodology. Results A total of 12 studies were included in this review, including 6 quantitative studies and 6 qualitative studies. The quantitative results provide preliminary indication of several physical, biological, psychological and macro-level contextual factors associated with psychosocial functioning in this clinical population. The qualitative findings shed light on a range of physical, psychosocial, and existential challenges faced by advanced oesophago-gastric cancer patients. These multiple and often persistent challenges appear to cause considerable distress; however, patients describe the importance of maintaining a sense of normality and control over their illness and its effects. Patients value continuity and structure, however many report shortcomings when accessing care. No findings reporting the experiences from the perspective of carers were found, therefore all findings represent the perspective of the patient. Conclusions Further high-quality research is needed to understand how best to support and manage the palliative care needs of individuals living with advanced oesophago-gastric cancer. Implications for practice are discussed, suggesting that psychosocial interventions, complex symptom management and continuity of care could improve the psychosocial functioning of individuals in this setting. Pre-registration The systematic review was pre-registered at the International Prospective Register of Systematic Reviews (PROSPERO; CRD42020181273) and the protocol can be viewed on the OSF (http://osf.io/exuzf)

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Psychological distress and health-related quality of life up to 2 years after oesophageal cancer surgery: nationwide population-based study

Cited by 17 publications

References 41 publications

Dispositional optimism and all-cause mortality after esophageal cancer surgery: a nationwide population-based cohort study

Dispositional optimism and all-cause mortality after esophageal cancer surgery: a nationwide population-based cohort study

Prevalence, nature and trajectory of dysphagia postoesophageal cancer surgery: a prospective longitudinal study protocol

Psychosocial functioning in individuals with advanced oesophago-gastric cancer: a mixed methods systematic review

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