P156 ASSESSMENT OF HEALTH RELATED QUALITY OF LIFE AND DIGESTIVE SYMPTOMS IN LONG-TERM, DISEASE FREE SURVIVORS AFTER ESOPHAGECTOMY. (23rd November 2019)

• Record Type: Journal Article
• Authors: Boshier, P R; Klevebro, F; Savva, K V; Waller, A; Hage, L; Hanna, G B; Low, D E
• Is Part Of: Diseases of the esophagus. Volume 32(2019)Supplement 2
• Publication Date: 2019-11-23
• Subjects: Esophagus -- Diseases -- Periodicals; 616.32
• DOI: 10.1093/dote/doz092.156
• Languages: English
• ISSNs: 1120-8694

Abstract

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