Impacts of anastomotic complications on the health-related quality of life after esophagectomy

J Surg Oncol. 2015 Mar 15;111(4):365-70. doi: 10.1002/jso.23837. Epub 2014 Nov 21.

Abstract

Backgroud and objectives: Health-related quality of life (HRQL) is of great importance in cancer management. The aim was to identify factors that influence postoperative HRQL in esophageal carcinoma patients.

Methods: A prospective cohort study was conducted to enroll 196 patients with esophageal carcinoma from November 2012 to June 2013. Sociademographic and clinicopathological parameters were recorded in detail. EORTC-QLQ C30 and ES18 were used to assess HRQL before surgery, at discharge, 1 and 6 months after discharge. Logistic regression models were used to identify factors independently influencing quality of life at 6 months after discharge.

Results: HRQL dramatically decreased after esophagectomy, but restored within 6 months in the most scales. Multivariate logistic regression analysis showed that gender (P = 0.002) and anastomotic stricture (P = 0.001) were the independent predictors of poor global quality-of-life 6 months after discharge. Anastomotic stricture occurred in 22 patients (11.2%), and their performance in social function (P = 0.04), problems with eating (P = 0.006), choking when swallowing (P < 0.001) were significantly poorer at 6 months after discharge. There were not significant differences in global quality-of-life between patients with and without anastomotic leakage at three postoperative assessments.

Conclusions: Postoperative HRQL is restored within 6 months after discharge. Occurrence of anastomotic stricture significantly decreases HRQL after esophagectomy.

Keywords: esophageal cancer; esophagectomy; quality of life; stricture.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anastomosis, Surgical / adverse effects*
  • Carcinoma / surgery
  • Esophageal Neoplasms / surgery*
  • Esophageal Stenosis / etiology
  • Esophageal Stenosis / psychology
  • Esophagectomy*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prospective Studies
  • Quality of Life*
  • Sex Factors