Prospective analysis of quality of life after surgical resection for esophageal cancer: preliminary results

BACKGROUND AND OBJECTIVES: This pilot study prospectively evaluates the impact of esophageal resection on health-related quality of life (HRQL) and mood states at diagnosis and during the first year after surgery. METHODS: Participants included 38 patients with planned esophageal resection. Two instruments were used: the Functional Assessment in Cancer Therapy core instrument with the esophageal subscale (FACT-E), and the Profile of Mood States (POMS). Subjects were evaluated after diagnosis and at 1, 3, 6, 9, and 12 months after surgical resection. RESULTS: All subjects demonstrated a decrease in overall HRQL after resection with a gradual return toward baseline by month 9. The functional and physical subscales of the FACT-E demonstrated the largest decrease at 1 month with a gradual return toward baseline. The POMS subscales that demonstrated the highest amount of disorder after surgery were tension, fatigue, and vigor. Although the trends were similar between patients undergoing surgery alone (n = 18) and those with neoadjuvant therapy (n = 20), the group that had received surgery alone demonstrated a higher HRQL and less mood disorder during the postoperative period, as compared with the neoadjuvant group. CONCLUSIONS: Patient perceptions of HRQL and mood states change over the first 12 months after esophageal resection. Although no statistically significant differences were found in this study, several trends were identified. Ongoing assessments of these changes are important, and interventions need to be developed and implemented to produce an effective decrease in the impact of esophageal resection on HRQL and mood states, particularly after trimodality therapy.