Long-term health-related quality of life after McKeown and Ivor Lewis esophagectomy for esophageal carcinoma.
esophageal neoplasms
esophagectomy
postoperative complications
quality of life
Journal
Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
ISSN: 1442-2050
Titre abrégé: Dis Esophagus
Pays: United States
ID NLM: 8809160
Informations de publication
Date de publication:
18 Nov 2020
18 Nov 2020
Historique:
received:
17
12
2019
revised:
19
02
2020
accepted:
30
03
2020
pubmed:
24
5
2020
medline:
29
7
2021
entrez:
24
5
2020
Statut:
ppublish
Résumé
Both cervical (McKeown) and intrathoracic (Ivor Lewis) anastomosis of transthoracic esophagectomy are surgical procedures that can be performed for distal esophageal or gastro-esophageal junction (GEJ) cancer. The purpose of this study was to investigate the long-term health-related quality of life (HR-QoL) after McKeown and Ivor Lewis esophagectomy in a tertiary referral center. Disease-free patients >1 year following a McKeown or an Ivor Lewis esophagectomy with a two-field lymphadenectomy for a distal or GEJ carcinoma visiting the outpatient clinic between 2014 and 2018 were asked to complete the EORTC QLQ-C30 and EORTC QLQ-OG25 questionnaires. HR-QoL was investigated in both groups. A total of 89 patients were included after McKeown and 115 after Ivor Lewis esophagectomy. Median follow-up was 2.4 years (IQR 1.7-3.6). Patients after McKeown esophagectomy reported more problems with 'eating with others' compared to patients after Ivor Lewis esophagectomy (mean scores: 49.9 vs. 38.8). This difference was both clinically relevant and significant after correction for multiple testing (β = 11.1, 95% CI 3.105-19.127, P = 0.042). Patients in both groups reported a poorer HR-QoL (≥10 points) than the general population with respect to nausea and vomiting, dyspnea, appetite loss, financial difficulties, problems with eating, reflux, eating with others, choked when swallowing, trouble with coughing, and weight loss. Long-term HR-QoL of disease-free patients following a McKeown or Ivor Lewis esophagectomy for a distal or GEJ carcinoma is largely comparable. Irrespective of the surgical technique, patients' HR-QoL following esophagectomy is compromised. When given the choice, patients should be informed that after a McKeown esophagectomy more problems while eating with others can occur.
Identifiants
pubmed: 32444879
pii: 5842244
doi: 10.1093/dote/doaa022
pmc: PMC7672202
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© The Author(s) 2020. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus.
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