TY - JOUR
T1 - Lasting Symptoms After Esophageal Resection (LASER)
T2 - European Multicenter Cross-sectional Study
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 - van Hillegersberg, Richard
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 - van Lanschot, Jan
AU - Nilsson, Magnus
AU - Reynolds, John V.
AU - Henegouwen, Mark I. van Berge
AU - Hanna, George B.
N1 - Funding Information: Mr S.R.M. received the European Society for Medical Oncology Clinical Research Fellowship for the support of this study. Mr S.R.M. is supported by an NIHR Academic Clinical Lectureship and acknowledges support from the National Institute for Health Research (NIHR) Imperial Biomedical Research Centre (BRC). This study was also 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. Publisher Copyright: © 2022 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2022/2/1
Y1 - 2022/2/1
N2 - Objective:To identify the most prevalent symptoms and those with greatest impact upon health-related quality of life (HRQOL) among esophageal cancer survivors.Background:Long-term symptom burden after esophagectomy, and associations with HRQOL, are poorly understood.Patients and Methods:Between 2010 and 2016, patients from 20 European Centers who underwent esophageal cancer surgery, and were disease-free at least 1 year postoperatively were asked to complete LASER, EORTC-QLQ-C30, and QLQ-OG25 questionnaires. Specific symptom questionnaire items that were associated with poor HRQOL as identified by EORTC QLQ-C30 and QLQ-OG25 were identified by multivariable regression analysis and combined to form a tool.Results:A total of 876 of 1081 invited patients responded to the questionnaire, giving a response rate of 81%. Of these, 66.9% stated in the last 6 months they had symptoms associated with their esophagectomy. Ongoing weight loss was reported by 10.4% of patients, and only 13.8% returned to work with the same activities.Three LASER symptoms were correlated with poor HRQOL on multivariable analysis; pain on scars on chest (odds ratio (OR) 1.27; 95% CI 0.97-1.65), low mood (OR 1.42; 95% CI 1.15-1.77) and reduced energy or activity tolerance (OR 1.37; 95% CI 1.18-1.59). The areas under the curves for the development and validation datasets were 0.81 ± 0.02 and 0.82 ± 0.09 respectively.Conclusion:Two-thirds of patients experience significant symptoms more than 1 year after surgery. The 3 key symptoms associated with poor HRQOL identified in this study should be further validated, and could be used in clinical practice to identify patients who require increased support.
AB - Objective:To identify the most prevalent symptoms and those with greatest impact upon health-related quality of life (HRQOL) among esophageal cancer survivors.Background:Long-term symptom burden after esophagectomy, and associations with HRQOL, are poorly understood.Patients and Methods:Between 2010 and 2016, patients from 20 European Centers who underwent esophageal cancer surgery, and were disease-free at least 1 year postoperatively were asked to complete LASER, EORTC-QLQ-C30, and QLQ-OG25 questionnaires. Specific symptom questionnaire items that were associated with poor HRQOL as identified by EORTC QLQ-C30 and QLQ-OG25 were identified by multivariable regression analysis and combined to form a tool.Results:A total of 876 of 1081 invited patients responded to the questionnaire, giving a response rate of 81%. Of these, 66.9% stated in the last 6 months they had symptoms associated with their esophagectomy. Ongoing weight loss was reported by 10.4% of patients, and only 13.8% returned to work with the same activities.Three LASER symptoms were correlated with poor HRQOL on multivariable analysis; pain on scars on chest (odds ratio (OR) 1.27; 95% CI 0.97-1.65), low mood (OR 1.42; 95% CI 1.15-1.77) and reduced energy or activity tolerance (OR 1.37; 95% CI 1.18-1.59). The areas under the curves for the development and validation datasets were 0.81 ± 0.02 and 0.82 ± 0.09 respectively.Conclusion:Two-thirds of patients experience significant symptoms more than 1 year after surgery. The 3 key symptoms associated with poor HRQOL identified in this study should be further validated, and could be used in clinical practice to identify patients who require increased support.
KW - esophageal cancer
KW - quality of life
KW - survivorship
KW - symptoms
UR - http://www.scopus.com/inward/record.url?scp=85123199530&partnerID=8YFLogxK
U2 - https://doi.org/10.1097/SLA.0000000000003917
DO - https://doi.org/10.1097/SLA.0000000000003917
M3 - Article
C2 - 32404661
SN - 0003-4932
VL - 275
SP - E392-E400
JO - Annals of surgery
JF - Annals of surgery
IS - 2
ER -