Quality of life after esophageal resection

Abstract

IntroductionEsophageal resection is the primary treatment for malignant esophageal disease and the last resort for benign end-stage esophageal disease. There is a paucity of research comparing the long-term quality of life (QoL) following surgery among these two populations. The aim of this study was to examine the patient reported QoL after esophageal resection using questionnaires focusing on general well-being and esophageal-specific symptoms.MethodsA prospectively maintained database of post-operatively administered European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) with supplemental esophageal cancer-specific questionnaires (OES-18) was queried after institutional review board approval through Creighton University School of Medicine. Inclusions were made if patients received an esophageal resection for benign or malignant esophageal disease. Emergency procedures, delayed reconstructions, and stage IV disease were excluded. Student’s t-test was used for domains of function, symptoms, QoL, and esophageal-specific complaints to compare the groups with each other and with the general population.ResultsA total of 39 out of 248 patients with malignant disease and 24 out of 46 with benign disease completed the questionnaire. A mean post-operative follow-up of 53 months with a response rate of 40% was obtained. There was no difference in physical (p=0.81), role (p =0.37), conditional (p=0.73), emotional (p=0.06), or social functions (p=0.42) between the general population and the esophageal resection groups. There was also no significant difference in generalized pain (p=0.86), nausea/vomiting (p=0.27), fatigue (p=0.86), swallowing (p=0.35), or esophageal pain (p=0.12). The malignant cohort had better outcomes than the benign cohort with respect to eating (p=0.04), indigestion (p=0.04), and QoL (p=<0.01).DiscussionThe underlying disease between these cohorts is drastically different, but postoperative functional status, generalized symptoms, swallowing ability, and esophageal pain were similar. There was no difference in functional status between the general population and the esophageal resection cohorts. Patients with malignant disease reported less problems with eating and a better QoL than their benign counterparts.

Qualidade de vida em pessoas acometidas por câncer de esôfago: uma Revisão de literatura/ Quality of life in people with esophageal cancer: a literature review

“…Além disso, estes pacientes acometidos pela doença benigna de esôfago em estágio terminal foram considerados mais sensíveis a desenvolverem distúrbios de natureza psicológica, como a ansiedade e a depressão, bem como relataram Brazilian Journal of Health Review, Curitiba, v.4, n.2, p. 7455-7463 mar./apr. 2021 problemas estatisticamente maiores com a alimentação e a indigestão, quando comparados à coorte maligna (SVETANOFF et al, 2018).…”

Patient-reported outcomes 1 year after oesophageal cancer surgery

“…However, a recent study comparing HRQL in patients with malign versus benign oesophageal resection, found few differences in long-term HRQL outcomes. Surprisingly enough, patients with malign diseases reported better quality of life and fewer eating problems [32], which could possibly be a result of response shift [33].…”

Long-Term Quality of Life in Achalasia Patients After Esophagectomy: A Single Center Experience

“…Svetanoff et al have hypothesized that the impact of surviving cancer alone may be beneficial to an individual’s QOL after esophagectomy. 21…”

“…21 They compared the impact of esophagectomy for malignant versus benign esophageal disease on QOL using the EORTC-OES 18 and 30 questionnaires. 21 In their study, 58.3% (n = 14) of patients in the benign disease group had end-stage achalasia. 21 Their results showed better QOL scores for patients who underwent esophagectomy for malignant disease compared to benign conditions, which is consistent with the findings in our study.…”