TY - JOUR
T1 - Influence of postoperative complications following esophagectomy for cancer on quality of life
T2 - A European multicenter study
AU - Schuring, N.
AU - Jezerskyte, E.
AU - van Berge Henegouwen, M. I.
AU - Sprangers, M. A. G.
AU - Lagergren, P.
AU - Johar, A.
AU - Markar, S. R.
AU - Gisbertz, S. S.
AU - Markar, Sheraz R.
AU - Zaninotto, Giovanni
AU - Castoro, Carlo
AU - Johar, Asif
AU - Lagergren, Pernilla
AU - Elliott, Jessie A.
AU - Gisbertz, Suzanne S.
AU - Mariette, Christophe
AU - Alfieri, Rita
AU - Huddy, Jeremy
AU - Sounderajah, Viknesh
AU - Pinto, Eleonora
AU - Scarpa, Marco
AU - Klevebro, Fredrik
AU - Sunde, Berit
AU - Murphy, Conor F.
AU - Greene, Christine
AU - Ravi, Narayanasamy
AU - Piessen, Guillaume
AU - Brenkman, Hylke
AU - Ruurda, Jelle P.
AU - Hillegersberg, Richard Van
AU - Lagarde, Sjoerd
AU - Wijnhoven, Bas
AU - Pera, Manuel
AU - Roig, José
AU - Castro, Sandra
AU - Matthijsen, Robert
AU - Findlay, John
AU - Antonowicz, Stefan
AU - Maynard, Nick
AU - McCormack, Orla
AU - Ariyarathenam, Arun
AU - Sanders, Grant
AU - Cheong, Edward
AU - Jaunoo, Shameen
AU - Allum, William
AU - Lanschot, Jan Van
AU - LASER study group
AU - Nilsson, Magnus
AU - Reynolds, John V.
AU - van Berge Henegouwen, Mark I.
AU - Hanna, George B.
N1 - Funding Information: M.I. van Berge Henegouwen has a consultant role with Mylan, Johnson and Johnson, Alesi Surgical, B. Braun and Medtronic. Research funding from Stryker.S.R. Markar received the European Society for Medical Oncology Clinical Research Fellowship for the support of this study. S.R. Markar is supported by an NIHR Academic Clinical Lectureship and acknowledges support from the National Institute for Health Research (NIHR) Imperial Biomedical Research Centre (BRC). Pernilla Lagergren is supported by the NIHR Imperial Biomedical Research Centre for her position at Imperial College London, London, UK. This LASER study was supported by the NIHR London IVD Co-operative and the Morgagni Charity. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health. G. Zaninotto reports support from the Morgagni Foundation The authors report no conflicts of interest. Funding Information: M.I. van Berge Henegouwen has a consultant role with Mylan, Johnson and Johnson, Alesi Surgical, B. Braun and Medtronic. Research funding from Stryker . Publisher Copyright: © 2022 The Authors
PY - 2022
Y1 - 2022
N2 - Introduction: Postoperative complications following major surgery have been shown to be associated with reduced health-related quality of life (HRQL), and severe complications may have profound negative effects. This study aimed to examine whether long-term HRQL differs with the occurrence and severity of complications in a European multicenter prospective dataset of patients following esophagectomy for cancer. Methods: Disease-free patients following esophagectomy for cancer between 2010 and 2016 from the LASER study were included. Patients completed the LASER, EORTC QLQ-C30 and EORTC QLQ-OG25 questionnaires >1 year following treatment. Long-term HRQL was compared between patients with and without postoperative complications, subgroup analysis was performed for severity of complications (no, minor [Clavien-Dindo I-II], severe [Clavien-Dindo ≥ III]), using univariable and multivariable regression. Results: 645 patients were included: 283 patients with no, 207 with minor and 155 with severe complications. Significantly more dyspnea (QLQ-C30) was reported by patients with compared to patients without complications (differenceinmeans 6.3). In subgroup analysis, patients with severe complications reported more dyspnea (difference in means 8.3) than patients with no complications. None of the differences were clinically relevant (difference in means ≥ 10 points). LASER-based low mood (OR2.3) was statistically different for minor versus severe complications. Conclusion: Comparable HRQL was found in patients with and without postoperative complications following esophagectomy for cancer, after a mean follow-up of 4.4 years. Furthermore, patients with different levels of severity of complications had comparable HRQL. The level of HRQL in esophageal cancer patients are more likely explained by the impact of the complex procedure of the esophagectomy itself.
AB - Introduction: Postoperative complications following major surgery have been shown to be associated with reduced health-related quality of life (HRQL), and severe complications may have profound negative effects. This study aimed to examine whether long-term HRQL differs with the occurrence and severity of complications in a European multicenter prospective dataset of patients following esophagectomy for cancer. Methods: Disease-free patients following esophagectomy for cancer between 2010 and 2016 from the LASER study were included. Patients completed the LASER, EORTC QLQ-C30 and EORTC QLQ-OG25 questionnaires >1 year following treatment. Long-term HRQL was compared between patients with and without postoperative complications, subgroup analysis was performed for severity of complications (no, minor [Clavien-Dindo I-II], severe [Clavien-Dindo ≥ III]), using univariable and multivariable regression. Results: 645 patients were included: 283 patients with no, 207 with minor and 155 with severe complications. Significantly more dyspnea (QLQ-C30) was reported by patients with compared to patients without complications (differenceinmeans 6.3). In subgroup analysis, patients with severe complications reported more dyspnea (difference in means 8.3) than patients with no complications. None of the differences were clinically relevant (difference in means ≥ 10 points). LASER-based low mood (OR2.3) was statistically different for minor versus severe complications. Conclusion: Comparable HRQL was found in patients with and without postoperative complications following esophagectomy for cancer, after a mean follow-up of 4.4 years. Furthermore, patients with different levels of severity of complications had comparable HRQL. The level of HRQL in esophageal cancer patients are more likely explained by the impact of the complex procedure of the esophagectomy itself.
KW - Esophageal neoplasms
KW - Esophagectomy
KW - Postoperative complications
KW - Quality of life
UR - http://www.scopus.com/inward/record.url?scp=85136145205&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.ejso.2022.07.020
DO - https://doi.org/10.1016/j.ejso.2022.07.020
M3 - Article
C2 - 35987796
SN - 0748-7983
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
ER -