180. ENHANCED RECOVERY PROTOCOL VERSUS CONVENTIONAL CARE IN ESOPHAGECTOMY PATIENTS WITH ESOPHAGEAL CARCINOMA: ADVANTAGES ON THE PATIENT-REPORTED OUTCOMES

Abstract

Abstract Background The subjective metrics regarding quality of life are unclear in comparison of an enhanced recovery after surgery (ERAS) protocol with conventional care in esophagectomy patients with esophageal carcinoma, while the objective metrics are controversial. This study was to investigate the advantages of ERAS over conventional care on the Health-related Quality of Life (HRQoL) from patient-reported outcomes (PROs), and explore the key components of ERAS for benefit duration. Methods This was a single-center, retrospective study with prospective PROs data from esophagectomy patients with esophageal cancer between April 2019 and June 2021. The objective metrics included perioperative complications and postoperative length of stay (PLOS). PROs data were assessed using the European Organization for Research and Treatment of Cancer QLQ-C30 quality of life questionnaire and the QLQ-OES18 esophageal cancer module from pre-surgery to six months after surgery. Mixed-effects models were used to longitudinally compare the HRQoL scores between the two programs. Results 348 conventional care and 109 ERAS patients were analyzed. The ERAS group had less pneumonia, arrhythmia, and PLOS than the conventional group. The ERAS group outperformed the conventional group in six QLQ-C30 domains, especially physical functioning (p = 0.0115), role functioning (p = 0.0002), and fatigue (p = 0.0428). QLQ-OES18 revealed that the ERAS group had less dysphagia (p < 0.0001), trouble talking (p = 0.0006) and better eating (p < 0.0001) than the conventional group. The above advantages persisted three months after surgery. For cervical circular stapled anastomosis the initial items and duration of benefit were reduced in ERAS group than in conventional group. Conclusion The ERAS protocol has significant advantages over the conventional care in lowering postoperative symptom burden and improving HRQoL on PROs in esophagectomy patients with esophageal cancer, and the benefit persists up to three months after surgery. For the cervical anastomosis the optimal technique may be a key component of ERAS maintaining the items and duration of advantages on PROs.