scholarly journals Long-term health-related quality of life after McKeown and Ivor Lewis esophagectomy for esophageal carcinoma

2020 ◽  
Vol 33 (11) ◽  
Author(s):  
E Jezerskyte ◽  
L M Saadeh ◽  
E R C Hagens ◽  
M A G Sprangers ◽  
L Noteboom ◽  
...  
Keyword(s):  
Health Related Quality ◽  
Ivor Lewis ◽  
Ivor Lewis Esophagectomy ◽  
Related Quality ◽  
Health Related ◽  
Eortc Qlq ◽  
Mckeown Esophagectomy ◽  
Disease Free

Summary Introduction Both cervical (McKeown) and intrathoracic (Ivor Lewis) anastomosis of transthoracic esophagectomy are surgical procedures that can be performed for distal esophageal or gastro-esophageal junction (GEJ) cancer. The purpose of this study was to investigate the long-term health-related quality of life (HR-QoL) after McKeown and Ivor Lewis esophagectomy in a tertiary referral center. Methods Disease-free patients >1 year following a McKeown or an Ivor Lewis esophagectomy with a two-field lymphadenectomy for a distal or GEJ carcinoma visiting the outpatient clinic between 2014 and 2018 were asked to complete the EORTC QLQ-C30 and EORTC QLQ-OG25 questionnaires. HR-QoL was investigated in both groups. Results A total of 89 patients were included after McKeown and 115 after Ivor Lewis esophagectomy. Median follow-up was 2.4 years (IQR 1.7–3.6). Patients after McKeown esophagectomy reported more problems with ‘eating with others’ compared to patients after Ivor Lewis esophagectomy (mean scores: 49.9 vs. 38.8). This difference was both clinically relevant and significant after correction for multiple testing (β = 11.1, 95% CI 3.105–19.127, P = 0.042). Patients in both groups reported a poorer HR-QoL (≥10 points) than the general population with respect to nausea and vomiting, dyspnea, appetite loss, financial difficulties, problems with eating, reflux, eating with others, choked when swallowing, trouble with coughing, and weight loss. Conclusion Long-term HR-QoL of disease-free patients following a McKeown or Ivor Lewis esophagectomy for a distal or GEJ carcinoma is largely comparable. Irrespective of the surgical technique, patients’ HR-QoL following esophagectomy is compromised. When given the choice, patients should be informed that after a McKeown esophagectomy more problems while eating with others can occur.

P156 ASSESSMENT OF HEALTH RELATED QUALITY OF LIFE AND DIGESTIVE SYMPTOMS IN LONG-TERM, DISEASE FREE SURVIVORS AFTER ESOPHAGECTOMY

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
P R Boshier ◽  
F Klevebro ◽  
K V Savva ◽  
A Waller ◽  
L Hage ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Gastrointestinal Symptoms ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Eortc Qlq ◽  
Disease Free ◽  
Over Time

Abstract Background Esophagectomy has been associated with decreased health related quality of life (HRQOL) and persistent gastrointestinal symptoms. The aim of this study was to investigate HRQOL and symptom evolution in disease free patients up to 20 years following esophagectomy. Methods The study cohort was identified from prospective, IRB approved esophagectomy databases from two high volume centers for the management of esophageal cancer. Patients that were alive and without evidence of disease recurrence in April 2018 completed HRQOL and symptom questionnaires, including: Digestive Symptom Questionnaire, SF36, EORTC QLQ-C30, and EORTC QLQ-OG25. Patients were assessed in three cohorts: <2 year; 2 to 5 years, and; >5 years following surgery. Results In total 171 patients who underwent esophagectomy between 1995-2017, responded to the questionnaires, corresponding to a response rate of 81.3%. Median age was 66.2 years, and median time from operation to survey was 5.6 years (range 0.3-23.1). Early satiety was the most commonly reported symptom in all patients irrespective of timeframe (87.4%; range 82-92%). Dysphagia was seen to decrease over time (58% at <2yrs; 28% at 2-5yrs; 20% at >5 yrs. P=0.013). Weight loss scores demonstrated non-statistical improvement over time. All other symptom scores including heartburn, regurgitation, respiratory symptoms and pain scores remained constant over time. The average level of HRQOL did not improve from levels one year after surgery compared to patients up to 23 years following esophagectomy. Conclusion With the exception of dysphagia, which improved over time, esophagectomy was associated with decreased HRQOL and lasting gastrointestinal symptoms >20 years after surgery. In additional to oncological outcomes, the impact of esophagectomy on long-term HRQOL and associated functional disorders should be considered by all members of the multidisciplinary team when counseling and caring for patients undergoing esophagectomy

736 PL11.04 HEALTH-RELATED QUALITY OF LIFE OF PATIENTS WITH ESOPHAGEAL CANCER FOLLOWING ESOPHAGECTOMY TREATED WITH NEOADJUVANT CHEMORADIOTHERAPY OR CHEMOTHERAPY: EUROPEAN MULTICENTER STUDY

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Nannet Schuring ◽  
Sheraz Markar ◽  
Eliza R C Hagens ◽  
Egle Jezerskyte ◽  
Mirjam A G Sprangers ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Neoadjuvant Chemoradiotherapy ◽  
P Value ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
The Mean ◽  
Eortc Qlq

Abstract   Curative treatment for patients with esophageal cancer consists of neoadjuvant treatment and radical surgical resection. Two different strategies exist; patients can either be treated with perioperative chemotherapy (CT) or neoadjuvant chemoradiotherapy (CRT). Both strategies improve 5-year survival rates, it is however not known if these treatments affect long-term Health-Related Quality of Life (HR-QoL) differently. The aim of this study was to compare HR-QoL between patients following CT and CRT followed by esophagectomy for esophageal cancer. Methods The LASER study database comprises data of a multicenter European study, with focus on HR-QoL among disease-free patients at least one year following an esophagectomy for esophageal or junctional cancer. Included patients completed the LASER, EORTC-QLQ-C30 and EORTC-QLQ-OG25 questionnaires. From this database we extracted patients either treated with CT or CRT for analysis. The primary endpoint was the mean difference in all long-term HR-QoL domains and LASER key symptom scores, using univariable and multivariable logistic regression analysis. The secondary endpoint was to compare the reported HR-QoL domain scores in the study population to the reference values of the general population. Results Among the 565 included patients, 349 (61.8%) received CRT, and 216 (38.2%) were treated with CT. The mean age was 63.7 years (±SD 8.6), and mean time since surgery was 4.3 years (±SD 1.7). After multivariable analysis, patients treated with CT reported worse outcomes on ‘Social Functioning’ (∆means 4.56, p-value&lt;0.05), more symptomatology on domains ‘Insomnia’ (∆means 5.65 p-value&lt;0.05) and ‘Diarrhea’ (∆means 5.93 p-value&lt;0.05) of the QLQ-C30 questionnaire, and more symptomatology on domains ‘Reflux’ (∆means 7.40, p-value&lt;0.05), ‘Odynophagia’(∆means 4.66 p-value&lt;0.05) and ‘Pain and discomfort’(∆means 4.34, p-value&lt;0.05) of the QLQ-OG25 questionnaire. No differences were observed for the LASER key symptoms. Conclusion Significant differences in favor of CRT were observed in several long-term HR-QoL domains for patients following esophagectomy for cancer. However, none of the observed differences in the reported long-term HR-QoL domains between patients treated with CT or with CRT, were clinically relevant (∆means≠ ≥ 10 points). Selection of neoadjuvant therapy should therefore be based on patient characteristics.

P13 DIFFERENCE IN LONG-TERM QUALITY OF LIFE BETWEEN MCKEOWN AND IVOR LEWIS ESOPHAGECTOMY

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
E Jezerskyte ◽  
L M Saadeh ◽  
E R C Hagens ◽  
M A G Sprangers ◽  
L Noteboom ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ivor Lewis ◽  
Ivor Lewis Esophagectomy ◽  
Significant Difference ◽  
Cardia Carcinoma ◽  
Eortc Qlq ◽  
Mckeown Esophagectomy

Abstract Aim The purpose of this study was to investigate the difference in long-term health-related quality of life (HR-QoL) between McKeown and Ivor Lewis esophagectomy in a tertiary referral center. Background & Methods The therapy of esophageal cancers consist of (neo)adjuvant chemo(radio)therapy and surgery. Often different surgical approaches are possible such as transthoracic esophagectomy with a cervical anastomosis (McKeown) or an intrathoracic anastomosis (Ivor Lewis). Evidence is scarce on whether either of these approaches is better in terms of survival, perioperative morbidity, pathology results and quality of life. Patients with mid-, distal esophageal, gastroesophageal (GEJ) or cardia carcinoma who have undergone a McKeown or an Ivor lewis esophagectomy in the period of 2003 – 2018 were included in this study. EORTC QLQ-C30 and EORTC QLQ-OG25 questionnaires were handed out during the outpatient clinic visits and a follow-up of at least one year was ensured. Problems with eating, reflux and nausea and vomiting were chosen as primary HR-QoL domain endpoints while the remaining HR-QoL domains, postoperative complications and pathology results were observed as secondary endpoints. Correction for confounders age and gender was performed. Results 147 patients were included in the McKeown group and 120 in the Ivor Lewis group. Mean age was 63.5 years and median follow-up was three years (range 12-137 months). No significant difference was found in problems with eating, reflux and nausea and vomiting. Significantly more problems with eating with others were found in McKeown group (β=10.435, 95% CI 4.474 – 16.395) and anastomotic leakage was significantly more common after McKeown esophagectomy (p=0.004). No significant difference was found in Clavien Dindo classification. During Ivor Lewis esophagectomy significantly more lymph nodes were resected (p<0.001). Number of lymph node metastases and R0 resection rate did not differ between groups. Conclusion No major differences in long-term HR-QoL were found in patients with mid-, distal esophageal, GEJ or cardia carcinoma following McKeown or Ivor Lewis esophagectomy. Problems with eating with others and anastomotic leakages were more common after McKeown esophagectomy, however, Clavien Dindo classification and radicality of surgery were similar between the two groups. Results of this study could assist the patient during the decision-making process prior to the surgery.

Long-Term Health-Related Quality of Life for Disease-Free Esophageal Cancer Patients

2011 ◽  
Vol 35 (8) ◽  
pp. 1853-1860 ◽  
Author(s):  
Claire L. Donohoe ◽  
Erin McGillycuddy ◽  
John V. Reynolds
Keyword(s):  
Quality Of Life ◽  
Esophageal Cancer ◽  
Cancer Patients ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Disease Free

Assessment of the Long-Term Impact of Pancreatoduodenectomy on Health-Related Quality of Life Using the EORTC QLQ-PAN26 Module

2021 ◽  
Author(s):  
Zhi Ven Fong ◽  
Yurie Sekigami ◽  
Motaz Qadan ◽  
Carlos Fernandez-del Castillo ◽  
Andrew L. Warshaw ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Eortc Qlq ◽  
Long Term Impact

scholarly journals 219 – Assessment of Health Related Quality of Life and Digestive Symptoms in Long Term, Disease Free Survivors Following Esophagectomy

2019 ◽  
Vol 156 (6) ◽  
pp. S-1388
Author(s):  
Fredrik Klevebro ◽  
Piers R. Boshier ◽  
K.V. Savva ◽  
Annabelle Waller ◽  
Lory Hage ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Disease Free

Assessment of Health Related Quality of Life and Digestive Symptoms in Long-term, Disease Free Survivors After Esophagectomy

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Piers R. Boshier ◽  
Fredrik Klevebro ◽  
Katerina V. Savva ◽  
Anabelle Waller ◽  
Lory Hage ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Disease Free

Health-related quality of life in long-term disease-free breast cancer survivors versus female population controls in Germany

2019 ◽  
Vol 175 (2) ◽  
pp. 499-510 ◽  
Author(s):  
Daniela Doege ◽  
Melissa Suk-Yin Thong ◽  
Lena Koch-Gallenkamp ◽  
Heike Bertram ◽  
Andrea Eberle ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Survivors ◽  
Health Related Quality ◽  
Female Population ◽  
Related Quality ◽  
Health Related ◽  
Disease Free ◽  
Population Controls
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