Long-Term Quality of Life After Esophagectomy for Esophageal Cancer |
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| Affiliation: | 1. Division of Thoracic and Upper Gastrointestinal Surgery, Department of Surgery, McGill University Health Center, Montreal, Quebec, Canada;2. Division of Experimental Surgery, Department of Surgery, McGill University, Montreal, Quebec, Canada;3. Faculty of Medicine, McGill University, Montreal, Quebec, Canada;1. Department of Cardiovascular and Thoracic Surgery, Rush University Medical Center, Chicago, Illinois;2. Rush Medical College, Chicago, Illinois;1. The Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio;2. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio;3. Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio;1. Division of Plastic Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota;2. Division of General Thoracic Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota;1. Division of Cardiac Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio;2. Section of Biostatistics, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio;3. Division of Pulmonary, Critical Care, and Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio;4. Division of Cardiology, The Ohio State University Wexner Medical Center, Columbus, Ohio |
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| Abstract: | BackgroundSurgery, as part of a multimodal approach, offers the greatest chance of cure for esophageal cancer. However, esophagectomy is often perceived as having a lasting impact on quality of life (QOL), biasing some physicians and patients toward nonoperative management. A comprehensive understanding of the dynamic changes in patient-centered outcomes is therefore important for decision making. Our objective was to determine the long-term QOL after esophagectomy.MethodsData were obtained from a prospectively collected (2006-2015) esophagectomy database at a high-volume center, and patients surviving 3 or more years were identified. Health-related QOL was evaluated using the Functional Assessment of Cancer Therapy-Esophageal Module (FACT-E) at diagnosis and every 3 to 6 months, and was stratified according to operative approach, stage, and complications. In addition, QOL scores were compared with normative population values.ResultsOf 480 patients, 47% (n = 226) survived 3 or more years and 70% (158 of 226) completed the health-related QOL assessments. Time of follow-up was 5.1 ± 2.8 years. After a reduction at 1 to 3 months, FACT-E increased from a baseline of 126 (95% CI, 121-131) to 133 (95% CI, 127-139) at 12 months, and to 147 (95% CI, 142-153) by 5 years. There was no difference in long-term FACT-E with respect to the surgical approach, clinical and pathologic stage, or postoperative complications. At long-term follow-up (more than 3 years), QOL did not differ significantly from the normative population reference values.ConclusionsThe long-term QOL of esophagectomy patients surviving at least 3 years is improved when compared with the time of diagnosis and does not differ from the general population. |
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