Health-related quality of life among patients cured by surgery for esophageal cancer

Authors

  • Pernilla Lagergren RN, PhD,

    1. Department of Social Medicine, University of Bristol, Bristol, United Kingdom
    2. Unit of Esophageal and Gastric Research (ESOGAR), Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
    3. Clinical Sciences at South Bristol, University of Bristol, Bristol, United Kingdom
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  • Kerry N. L. Avery PhD,

    1. Department of Social Medicine, University of Bristol, Bristol, United Kingdom
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  • Rachael Hughes MSc,

    1. Department of Social Medicine, University of Bristol, Bristol, United Kingdom
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  • C. Paul Barham MD, FRCS (Gen Surg),

    1. Division of Surgery, Head and Neck, United Bristol Healthcare Trust, Bristol, United Kingdom
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  • Derek Alderson MD, FRCS,

    1. Clinical Sciences at South Bristol, University of Bristol, Bristol, United Kingdom
    2. Division of Surgery, Head and Neck, United Bristol Healthcare Trust, Bristol, United Kingdom
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  • Stephen J. Falk MD, MRCP,

    1. Bristol Haematology and Oncology Centre, United Bristol Healthcare Trust, Bristol, United Kingdom
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  • Jane M. Blazeby MD, FRCS (Gen Surg)

    Corresponding author
    1. Department of Social Medicine, University of Bristol, Bristol, United Kingdom
    2. Clinical Sciences at South Bristol, University of Bristol, Bristol, United Kingdom
    3. Division of Surgery, Head and Neck, United Bristol Healthcare Trust, Bristol, United Kingdom
    • Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Clifton, Bristol, BS8 2PR, United Kingdom
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    • Fax: (011) 44 (0) 117 928 7292


Abstract

BACKGROUND.

Little is known regarding the long-term, health-related quality of life (HRQL) of survivors of esophagectomy for cancer.

METHODS.

Consecutive patients completed the validated European Organization for Research and Treatment of Cancer general quality-of life-questionnaire (QLQ-C30) and the esophageal-specific module (QLQ-OES18) before surgery and regularly thereafter for at least 3 years. Mean scores with 95% confidence intervals were calculated. The Student t test for paired data was used to determine differences between baseline and 3-year HRQL scores in which scores differed by ≥5 points.

RESULTS.

Of 90 patients who underwent surgery, 47 patients (52%) survived for ≥3 years. In this group, most aspects of HRQL recovered to preoperative levels by the 3-year assessment, except that scores for physical function, breathlessness, diarrhea, and reflux were significantly worse than at baseline (P < .01). However, patients reported significantly better emotional function 3 years after surgery than before treatment (P = .0008).

CONCLUSIONS.

Even after 3 years, patients who underwent esophagectomy suffered persistent problems with physical function and specific symptoms. These findings may be used to inform patients of the long-term consequences of surgery. Cancer 2007. © 2007 American Cancer Society.

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