Patient-reported outcomes after oesophagectomy in the multicentre LASER study
S Markar
(1, 2)
,
V Sounderajah
,
A Johar
,
G Zaninotto
(3)
,
C Castoro
,
P Lagergren
(4)
,
J Elliott
(5)
,
S Gisbertz
,
C Mariette
(6, 7)
,
R Alfieri
(8)
,
J Huddy
,
E Pinto
,
M Scarpa
(9)
,
F Klevebro
,
B Sunde
,
C Murphy
,
C Greene
,
N Ravi
,
G Piessen
(10, 7, 11)
,
H Brenkman
,
J Ruurda
,
R van Hillegersberg
,
S Lagarde
,
B Wijnhoven
,
M Pera
,
J Roigg
,
S Castro
,
R Matthijsen
,
J Findlay
,
S Antonowicz
,
N Maynard
,
O Mccormack
,
A Ariyarathenam
,
G Sanders
,
E Cheong
,
S Jaunoo
,
W Allum
,
J van Lanschot
,
M Nilsson
,
J Reynolds
,
M van Berge Henegouwen
,
G Hanna
1
Imperial College London
2 Karolinska Institutet [Stockholm]
3 Department of Surgery
4 Skane University Hospital [Lund]
5 MPE - Max-Planck-Institut für Extraterrestrische Physik
6 Hôpital Claude Huriez [Lille]
7 CANTHER - Hétérogénéité, Plasticité et Résistance aux Thérapies des Cancers = Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277
8 UNIPR - Università degli studi di Parma = University of Parma
9 Medical and Surgical Sciences
10 Department of Digestive and Oncological Surgery [Lille]
11 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
2 Karolinska Institutet [Stockholm]
3 Department of Surgery
4 Skane University Hospital [Lund]
5 MPE - Max-Planck-Institut für Extraterrestrische Physik
6 Hôpital Claude Huriez [Lille]
7 CANTHER - Hétérogénéité, Plasticité et Résistance aux Thérapies des Cancers = Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277
8 UNIPR - Università degli studi di Parma = University of Parma
9 Medical and Surgical Sciences
10 Department of Digestive and Oncological Surgery [Lille]
11 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
S Markar
- Function : Author
- PersonId : 1368205
- ORCID : 0000-0001-8650-2017
V Sounderajah
- Function : Author
- PersonId : 1368265
- ORCID : 0000-0002-4595-8402
A Johar
- Function : Author
C Castoro
- Function : Author
P Lagergren
- Function : Author
- PersonId : 1368142
- ORCID : 0000-0002-4634-0233
J Elliott
- Function : Author
- PersonId : 1368267
- ORCID : 0000-0003-4673-0386
S Gisbertz
- Function : Author
J Huddy
- Function : Author
E Pinto
- Function : Author
M Scarpa
- Function : Author
- PersonId : 1368268
- ORCID : 0000-0002-0217-6523
F Klevebro
- Function : Author
- PersonId : 1368269
- ORCID : 0000-0002-1695-4103
B Sunde
- Function : Author
C Murphy
- Function : Author
C Greene
- Function : Author
N Ravi
- Function : Author
H Brenkman
- Function : Author
- PersonId : 1368270
- ORCID : 0000-0003-4573-9143
J Ruurda
- Function : Author
R van Hillegersberg
- Function : Author
S Lagarde
- Function : Author
B Wijnhoven
- Function : Author
M Pera
- Function : Author
- PersonId : 1367945
- ORCID : 0000-0002-9449-1810
J Roigg
- Function : Author
S Castro
- Function : Author
R Matthijsen
- Function : Author
J Findlay
- Function : Author
S Antonowicz
- Function : Author
N Maynard
- Function : Author
O Mccormack
- Function : Author
A Ariyarathenam
- Function : Author
G Sanders
- Function : Author
E Cheong
- Function : Author
S Jaunoo
- Function : Author
W Allum
- Function : Author
J van Lanschot
- Function : Author
M Nilsson
- Function : Author
- PersonId : 1368230
- ORCID : 0000-0002-6215-8132
J Reynolds
- Function : Author
M van Berge Henegouwen
- Function : Author
G Hanna
- Function : Author
Abstract
Abstract Background Data on the long-term symptom burden in patients surviving oesophageal cancer surgery are scarce. The aim of this study was to identify the most prevalent symptoms and their interactions with health-related quality of life. Methods This was a cross-sectional cohort study of patients who underwent oesophageal cancer surgery in 20 European centres between 2010 and 2016. Patients had to be disease-free for at least 1 year. They were asked to complete a 28-symptom questionnaire at a single time point, at least 1 year after surgery. Principal component analysis was used to assess for clustering and association of symptoms. Risk factors associated with the development of severe symptoms were identified by multivariable logistic regression models. Results Of 1081 invited patients, 876 (81.0 per cent) responded. Symptoms in the preceding 6 months associated with previous surgery were experienced by 586 patients (66.9 per cent). The most common severe symptoms included reduced energy or activity tolerance (30.7 per cent), feeling of early fullness after eating (30.0 per cent), tiredness (28.7 per cent), and heartburn/acid or bile regurgitation (19.6 per cent). Clustering analysis showed that symptoms clustered into six domains: lethargy, musculoskeletal pain, dumping, lower gastrointestinal symptoms, regurgitation/reflux, and swallowing/conduit problems; the latter two were the most closely associated. Surgical approach, neoadjuvant therapy, patient age, and sex were factors associated with severe symptoms. Conclusion A long-term symptom burden is common after oesophageal cancer surgery.