Quality of life after esophageal resection

Figures & data

Figure 1 Flow diagram depicting inclusion of patients based on questionnaire response among all patients.

Table 1 Demographic characteristics of patients undergoing esophageal resection either for benign or malignant disease

Characteristics	Total included patients, n (%)	Malignant disease, n (%)	Benign disease, n (%)
Patients (N)	63	39	24
Gender
Male	43 (68.25)	33 (84.62)	10 (40.74)
Female	20 (31.75)	6 (15.38)	14 (59.26)
Age (years)
<40	0	0	0
40–49	1 (1.59)	0	1 (4.17)
50–59	23 (36.51)	15 (38.46)	8 (33.3)
60–69	22 (34.92)	16 (41.03)	6 (25.00)
70–79	16 (25.40)	7 (17.95)	9 (37.50)
80+	1 (1.59)	1 (2.56)	0
Comorbidities
Yes	53 (84.13)	35 (89.74)	18 (75.00)
No	10 (15.87)	4 (10.26)	6 (25.00)
Dysplasia
HGD/EAC	N/A	36 (92.30)	N/A
SCC	N/A	3 (7.70)	N/A
Tumor location
Upper/Middle esophagus	N/A	1 (2.56)	N/A
Lower esophagus	N/A	33 (84.62)	N/A
Proximal stomach	N/A	5 (12.82)	N/A
Grade
0–I	N/A	10 (25.64)	N/A
II	N/A	25 (64.10)	N/A
III	N/A	4 (10.26)	N/A
Dysfunction
Achalasia	N/A	N/A	14 (58.33)
Diffuse esophageal spasm	N/A	N/A	2 (8.33)
Stricture	N/A	N/A	3 (12.50)
Mesh erosion	N/A	N/A	1 (4.17)
Gastroesophageal reflux disease	N/A	N/A	1 (4.17)
Diverticulum	N/A	N/A	1 (4.17)
Approach
Minimally invasive	30 (47.62)	25 (64.10)	5 (20.83)
Open	31 (49.21)	13 (33.33)	18 (75)
Hybrid	2 (3.17)	1 (2.56)	1 (4.17)
Conduit
Stomach	54 (85.71)	38 (97.44)	16 (66.67)
Jejunum	4 (6.35)	1 (2.56)	3 (12.50)
Colon	5 (7.94)	N/A	5 (20.83)
Anastomosis
Stapled	34 (53.97)	24 (61.54)	10 (41.67)
Hand-sewn	29 (46.03)	15 (38.46)	14 (58.33)

Abbreviations: HGD/EAC, high-grade dysplasia/early adenocarcinoma; SCC, squamous cell carcinoma; N/A, not applicable.

Table 2 Linear regression analysis of our total esophageal resection cohort compared to general population: functional domains (all questions are answered in the context of the past week)

Functional domain questions	General population (LRS)	Total patients with esophageal resection (LRS)	p-value
Physical function			0.24
Do you have any trouble doing strenuous activities?	76.05	67.72
Trouble with long walks?	84.28	66.22
Trouble taking short walk outside of house?	93.84	87.98
Do you need to stay in bed or a chair during the day?	95.41	82.79
Do you need help with eating? Dressing? Washing yourself or using the toilet?	98.74	97.37
Role function			0.40
Were you limited in doing your work?	84.09	84.31
Were you limited in pursuing your hobbies/leisure activities?	84.77	82.70
Generalized pain			0.97
Have you had pain in the past week?	22.98	29.42
Did pain interfere with your daily activities?	19.00	19.11
Nausea and vomiting			0.09
Have you felt nauseated?	5.62	14.02
Have you vomited?	1.90	10.14
Fatigue			0.13
Did you need to rest?	24.78	32.30
Were you tired?	28.84	38.85
Emotional function			0.70
Did you feel tense?	77.17	75.31
Did you worry?	72.18	67.15
Did you feel irritable?	75.59	79.17
Did you feel depressed?	79.76	77.99
Social function			0.09
Has your physical condition or medical treatment interfered with your family life?	87.92	79.55
Has your physical condition or medical treatment interfered with your social activities?	86.83	72.43
Generalized quality of life			0.65
How would you rate your overall health?	70.80	71.10
How would you rate your overall quality of life?	71.85	70.98
Conditional function			0.94
Have you had difficulty remembering things this past week?	88.77	78.72
Have you had difficulty with your daily activities?	83.33	87.82

Abbreviation: LRS, linear regression analysis.

Table 3 Linear regression analysis of the EORTC QLQ-C30 and specific esophageal symptoms of patients undergoing esophageal resection for benign and malignant disease

EORTC QLQ-C30 Domains	End stage benign disease (LRS)	Malignant disease (LRS)	p-value
Physical function			0.81
Do you have any trouble doing strenuous activities?	72.22	75.21
Trouble with long walks?	68.89	70.94
Trouble taking short walk outside of house?	89.25	94.17
Do you need to stay in bed or a chair during the day?	89.25	89.17
Do you need help with eating? Dressing? Washing yourself or using the toilet?	100.00	100.00
Role function			0.37
Were you limited in doing your work?	84.44	84.17
Were you limited in pursuing your hobbies/leisure activities?	79.57	85.83
Generalized pain			0.86
Have you had pain in the past week?	27.96	25.83
Did pain interfere with your daily activities?	16.13	15.00
Nausea and vomiting			0.27
Have you felt nauseated?	18.89	9.17
Have you vomited?	11.11	9.17
Fatigue			0.86
Did you need to rest?	29.03	28.33
Were you tired?	40.86	35.00
Emotional function			0.06
Did you feel tense?	79.57	71.04
Did you worry?	74.20	60.10
Did you feel irritable?	80.65	77.70
Did you feel depressed?	82.80	73.18
Social function			0.43
Has your physical condition or medical treatment interfered with your family life?	79.57	79.53
Has your physical condition or medical treatment interfered with your social activities?	73.12	71.74
Generalized quality of life			0.01
How would you rate your overall health?	67.20	75.00
How would you rate your overall quality of life?	66.13	75.83
Conditional function			0.73
Have you had difficulty remembering things this past week?	91.40	84.24
Have you had difficulty with your daily activities?	75.27	82.18
Esophageal-specific domains
Swallowing			0.35
During the past week could you eat solid food?	12.90	11.11
Could you eat liquefied or soft food? This past week	5.38	12.04
Could you drink liquids this past week?	3.23	8.33
Eating			0.04
Have you had trouble enjoying your meals?	48.93	20.37
Have you felt full up too quickly?	38.70	37.04
Have you had trouble with eating?	56.20	19.44
Have you had trouble with eating in front of other people?	28.07	8.33
Indigestion			0.04
Have you had acid indigestion or heartburn?	33.33	18.52
Have you had trouble with acid or bile coming into your mouth?	29.032	21.292
Pain			0.12
Have you had pain in your chest?	28.49	5.56

Notes: Only the generalized quality of life showed significant difference, with those in the malignant group claiming a better overall quality of life. The EORTC QLQ-C30 specimen was adapted and used with permission from the European Organization for Research and Treatment of Cancer; EORTC Quality of Life Department. EORTC QLQ-C30 (version 3). Available from: http://groups.eortc.be/qol/. © Copyright 1995 EORTC Quality of Life Group. All rights reserved. Version 3.0.³⁵ Please contact the EORTC Quality of Life Department for any further use of the questionnaire.

Abbreviations: EORTC QLQ-C30, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30; LRS, linear regression analysis.

European Organization for Research and Treatment of CancerEORTC Quality of Life DepartmentEORTC QLQ-C-30 (version 3) Available from: http://groups.eortc.be/qol/Accessed February 22, 2018

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