Patient-reported outcomes 1 year after oesophageal cancer surgery

Figures & data

Table 1. Patient- and clinical characteristics of (n = 281) patients in total and categorised by sex.

Characteristics	Categorisation	All patients	Men	Women
		Number (%)	Number (%)	Number (%)
Total		281 (100)	231 (82)	50 (18)
Age at surgery	<70 years	178 (64)	147 (63)	31 (62)
	≥70 years	103 (36)	84 (36)	19 (38)
Comorbidity	0	118 (42)	97 (42)	21 (42)
	≥1	163 (58)	134 (58)	29 (58)
Tumour histology	Squamous cell carcinoma	43 (15)	21 (9)	22 (44)
	Adenocarcinoma or dysplasia	235 (85)	207 (91)	28 (56)
Tumour location	Upper or middle oesophagus	31 (11)	19 (8)	12 (24)
	Lower oesophagus or cardia	247 (89)	210 (92)	37 (76)
Tumour stage^a	0–I	83 (32)	76 (92)	7 (8)
	II	82 (32)	68 (83)	14 (17)
	III–IV	83 (32)	70 (84)	13 (16)
Neoadjuvant therapy	Yes	223 (79)	183 (79)	40 (80)
	No	58 (21)	48 (21)	10 (20)

^a Missing data for 33 patients.

Table 2. Health-related quality of life (HRQL) limitations at 1 year after oesophageal cancer surgery are presented as numbers, proportions, mean scores and 95% confidence intervals (CIs).

	Poor HRQL		Good HRQL
	Numbers (%)	Mean scores (95% CI)	Numbers (%)	Mean scores (95% CI)
EORTC QLQ-C30^a
Global quality of life	27 (10)	19 (14–24)	254 (90)	69 (67–71)
Functional scales
Physical	113 (40)	65 (62–68)	168 (60)	94 (93–95)
Role	75 (27)	31 (27–36)	206 (73)	91 (90–93)
Emotional	60 (21)	54 (49–59)	221 (79)	90 (89–91)
Cognitive	44 (16)	49 (43–54)	237 (84)	90 (89–91)
Social	65 (23)	40 (35–44)	216 (77)	91 (90–93)
Symptom scales
Fatigue	114 (41)	57 (54–60)	167 (59)	18 (16–20)
Nausea/vomiting	47 (17)	52 (47–57)	234 (83)	9 (7–10)
Pain	63 (22)	61 (57–67)	218 (78)	9 (8–11)
Symptom items
Dyspnoea	68 (24)	74 (70–77)	213 (76)	17 (14–19)
Insomnia	56 (20)	78 (74–82)	225 (80)	9 (8–11)
Appetite loss	53 (19)	74 (70–77)	228 (81)	10 (8–12)
Constipation	17 (6)	73 (66–79)	264 (94)	4 (3–5)
Diarrhoea	36 (13)	75 (70–80)	245 (87)	12 (10–14)
Financial difficulties	25 (9)	81 (74–88)	256 (91)	4 (2–5)
EORTC QLQ-OG25^b
Functional scales
Body image	40 (14)	26 (21–30)	241 (86)	94 (93–96)
Symptom scales
Dysphagia	43 (15)	36 (31–41)	238 (85)	5 (4–6)
Eating restrictions	138 (49)	44 (41–48)	143 (51)	13 (12–15)
Reflux	72 (26)	64 (60–69)	209 (74)	11 (9–12)
Odynophagia	32 (11)	53 (46–60)	249 (79)	9 (7–10)
Pain and discomfort	56 (20)	63 (58–68)	225 (80)	14 (12–16)
Anxiety	100 (36)	68 (65–72)	181 (64)	19 (17–21)
Symptom items
Eating with others	20 (7)	75 (68–82)	261 (93)	3 (2–5)
Dry mouth	66 (23)	77 (73–81)	215 (77)	13 (11–15)
Problems with taste	38 (14)	76 (71–81)	243 (86)	9 (7–10)
Trouble swallowing saliva	12 (4)	81 (70–91)	269 (96)	4 (2–5)
Choking	20 (7)	70 (65–75)	261 (93)	9 (7–11)
Coughing	76 (27)	75 (71–78)	205 (73)	20 (18–22)
Speech difficulties	15 (5)	82 (73–92)	266 (95)	4 (3–6)
Weight loss	62 (22)	80 (75–84)	219 (78)	10 (8–12)
Hair loss	21 (7)	81 (73–89)	260 (93)	7 (4–10)
EORTC QLQ-CAX24^c
Multi-item scales
Food aversion	131 (47)	38 (35–42)	152 (53)	9 (8–11)
Eating and weight loss worry	78 (28)	65 (61–69)	205 (72)	13 (11–16)
Eating difficulties	72 (26)	46 (41–50)	211 (74)	11 (6–8)
Loss of control	82 (29)	37 (33–41)	201 (71)	7 (6–8)
Physical decline	34 (12)	44 (37–51)	249 (88)	4 (3–5)
Single items
Dry mouth	42 (15)	75 (71–80)	241 (85)	13 (11–16)
Heartburn	63 (22)	76 (72–80)	220 (88)	16 (13–19)
Forcing self to eat	47 (17)	71 (68–74)	236 (83)	12 (9–15)
Inadequate information	88 (31)	16 (12–19)	195 (69)	86 (83–90)
EORTC QLQ-FA13^d
Physical fatigue	116 (41)	50 (46–53)	167 (59)	13 (12–15)
Emotional fatigue	52 (19)	52 (46–59)	231 (81)	7 (6–8)
Cognitive fatigue	15 (5)	60 (49–71)	268 (95)	5 (4–6)
Single items
Tiredness interfered with daily activities	36 (13)	73 (69–78)	247 (87)	13 (11–15)
Tiredness not understood	9 (3)	93 (81–104)	274 (97)	4 (3–5)

The health-related quality of life (HRQL) scores were transformed into a scale ranging from 0 to 100 where higher scores corresponded to better HRQL, while higher scores for symptoms represented more problems. Poor HRQL was considered present if the patients reported ‘quite a bit’ or ‘very much’ to any item within a scale or to a single item. Good HRQL was considered present if the patients reported ‘not at all’ or ‘a little’ to all items within a scale or to a single item.

^a QLQ-C30: Quality of Life Questionnaire Core 30.

^b QLQ-OG25: Quality of Life Questionnaire Oesophago-Gastric module 25.

^c QLQ-CAX24: Quality of Life Questionnaire cancer Cachexia module 24.

^d QLQ-FA13: Quality of Life Questionnaire Cancer-related Fatigue 13.

Table 3. Psychological symptoms 1 year after oesophageal cancer surgery are presented as numbers, proportions, mean scores and 95% confidence intervals (CIs).

	Patients with psychological symptoms of concern		Patients with less psychological symptoms
	Numbers (%)	Mean scores (95% CI)	Numbers (%)	Mean scores (95% CI)
ASC^a
Cancer worry	80 (28)	2.6 ( 2.5–2.7)	201 (72)	1.4 (1.3–1.5)
General health worry	62 (22)	2.7 (2.5–2.8)	219 (78)	1.4 (1.3–1.5)
HADS^b
Anxiety	31 (11)	10.8 (9.9–11.8)	250 (89)	2.0 (1.7–2.3)
Depression	33 (12)	9 (9–10)	248 (88)	2.2 (2.0–2.5)
IES-R^c
Post-traumatic stress^c	48 (17)	36 (33–39)	233 (83)	7.6 (6.9–8.4)

^a ASC: Assessment of Survivor Concerns where a score above 2 corresponds to perceived fear of recurrence and general health worry.

^b HADS: Hospital Anxiety and Depression scale where ≥8 was used as a cut-off for clinically significant symptoms of anxiety or depression.

^c IES-R: Impact of Events-Revised where ≥24 is of clinical concern of posttraumatic stress.

Table 4. Proportion of patients with sleep problems 1 year after oesophageal cancer surgery are presented as numbers and proportions (n = 281).

Karolinska Sleep Questionnaire	Numbers (%)
Sleep problems	144 (51)
Insomnia	115 (41)
Awakening	61 (22)
Apnoea/snoring	30 (11)
Sleepiness	51 (18)
Poor overall sleep quality	29 (10)

Patients who stated that the sleep-related disturbances occurred ‘often’, ‘mostly’ or ‘always’ were regarded as having sleep problems.