Pilot Study of Patient-Reported Outcomes in Patients With Esophageal Cancer After Esophagectomy.


Journal

The Annals of thoracic surgery
ISSN: 1552-6259
Titre abrégé: Ann Thorac Surg
Pays: Netherlands
ID NLM: 15030100R

Informations de publication

Date de publication:
10 2022
Historique:
received: 29 10 2021
revised: 02 12 2021
accepted: 06 12 2021
pubmed: 17 1 2022
medline: 30 9 2022
entrez: 16 1 2022
Statut: ppublish

Résumé

Patient-reported outcomes (PROs) are critical measures of patient well-being after esophagectomy. In this pilot study, we assessed PROs before and after esophagectomy using the Patient Reported Outcomes Measurement Information System (PROMIS) to assess patient recovery after surgery. We prospectively collected PROMIS dyspnea severity, physical function, and pain interference measures from patients with esophageal cancer undergoing esophagectomy (2017-2020). We merged these data with our institutional Society of Thoracic Surgery esophagectomy database. We used linear mixed-effect multivariable models to assess changes in PROMIS scores (least square mean [LSM] differences) preoperatively and postoperatively at 1 and 6 months. The study included 112 patients undergoing esophagectomy. Pain interference, physical function, and dyspnea severity scores were significantly worse 1 month after surgery. While physical function and dyspnea severity scores returned to baseline 6 months after surgery, pain interference scores remained persistently worse (LSM difference, 2.7 ± 2.5; P = .036). PROMIS scores were further assessed among patients undergoing transhiatal esophagectomy compared with transthoracic esophagectomy. Physical function and dyspnea severity scores were similar between the groups at each assessment. However, pain interference scores were persistently better among patients undergoing THE at both 1 month (LSM difference, 6.5 ± 5.1; P = .013) and 6 months after surgery (LSM difference, 5.2 ± 3.9; P = .008). This pilot study assessing PROMIS scores after esophagectomy for cancer reveals that pain is a persistently reported symptom up to 6 months after surgery, particularly among patients receiving transthoracic esophagectomy.

Sections du résumé

BACKGROUND
Patient-reported outcomes (PROs) are critical measures of patient well-being after esophagectomy. In this pilot study, we assessed PROs before and after esophagectomy using the Patient Reported Outcomes Measurement Information System (PROMIS) to assess patient recovery after surgery.
METHODS
We prospectively collected PROMIS dyspnea severity, physical function, and pain interference measures from patients with esophageal cancer undergoing esophagectomy (2017-2020). We merged these data with our institutional Society of Thoracic Surgery esophagectomy database. We used linear mixed-effect multivariable models to assess changes in PROMIS scores (least square mean [LSM] differences) preoperatively and postoperatively at 1 and 6 months.
RESULTS
The study included 112 patients undergoing esophagectomy. Pain interference, physical function, and dyspnea severity scores were significantly worse 1 month after surgery. While physical function and dyspnea severity scores returned to baseline 6 months after surgery, pain interference scores remained persistently worse (LSM difference, 2.7 ± 2.5; P = .036). PROMIS scores were further assessed among patients undergoing transhiatal esophagectomy compared with transthoracic esophagectomy. Physical function and dyspnea severity scores were similar between the groups at each assessment. However, pain interference scores were persistently better among patients undergoing THE at both 1 month (LSM difference, 6.5 ± 5.1; P = .013) and 6 months after surgery (LSM difference, 5.2 ± 3.9; P = .008).
CONCLUSIONS
This pilot study assessing PROMIS scores after esophagectomy for cancer reveals that pain is a persistently reported symptom up to 6 months after surgery, particularly among patients receiving transthoracic esophagectomy.

Identifiants

pubmed: 35033508
pii: S0003-4975(22)00025-X
doi: 10.1016/j.athoracsur.2021.12.024
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1135-1141

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2022 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Auteurs

Brendan T Heiden (BT)

Division of Cardiothoracic Surgery, Department of Surgery, Washington University in St. Louis School of Medicine, St Louis, Missouri; Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, St Louis, Missouri.

Melanie P Subramanian (MP)

Division of Cardiothoracic Surgery, Department of Surgery, Washington University in St. Louis School of Medicine, St Louis, Missouri.

Jingxia Liu (J)

Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, St Louis, Missouri.

Angela Keith (A)

Division of Cardiothoracic Surgery, Department of Surgery, Washington University in St. Louis School of Medicine, St Louis, Missouri.

Kathryn E Engelhardt (KE)

Division of Cardiothoracic Surgery, Department of Surgery, Washington University in St. Louis School of Medicine, St Louis, Missouri.

Bryan F Meyers (BF)

Division of Cardiothoracic Surgery, Department of Surgery, Washington University in St. Louis School of Medicine, St Louis, Missouri.

Varun Puri (V)

Division of Cardiothoracic Surgery, Department of Surgery, Washington University in St. Louis School of Medicine, St Louis, Missouri.

Benjamin D Kozower (BD)

Division of Cardiothoracic Surgery, Department of Surgery, Washington University in St. Louis School of Medicine, St Louis, Missouri. Electronic address: kozower@wustl.edu.

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