729 RELATION OF POSTOPERATIVE MORBIDITY WITH QUALITY OF LIFE FOLLOWING ESOPHAGEAL SURGERY FOR CANCER: A EUROPEAN MULTICENTER STUDY

Abstract

Abstract Despite improvements in perioperative esophageal cancer care, severe postoperative complications occur in 17.2% of the patients. Postoperative complications are associated with reduced health-related quality of life (HR-QoL), and severe complications may have a profound negative effect on the HR-QoL.The aim of this study was to investigate the relation between postoperative morbidity and reported HR-QoL in patients following esophagectomy for cancer. Methods Disease-free patients at least one year following esophagectomy for cancer in one of the participating LASER study centers between 2010 and 2016 were included. Patients completed the LASER, EORTC-QLQ-C30 and QLQ-OG25 questionnaires at least one year following surgery. The primary outcome was the relation between reported HR-QoL and occurrence of postoperative complications and to compare the HR-QoL in the study population with the reference values of the general population. Subgroup analysis was performed in patients with ‘no’ or ‘minor’ (Clavien-Dindo grade I-IIIa) and ‘severe’ (Clavien-Dindo grade ≥ IIIb) complications, using univariable and multivariable logistic regression analysis. Results Among 645 included patients, 283 patients with ‘no’, 207 patients with ‘minor’ and 155 patients with ‘severe’ postoperative complications were included. The mean age of the patients was 64 years (SD 9), with a mean time since surgery of 4.4 years (SD 1.7). Neither significant or clinically relevant differences were found in the HR-QoL scores between patients with and without complications, nor were differences observed in subgroup analysis for severity of postoperative complications. Compared to the general population, patients reported worse HR-QoL in all domains except ‘Global Health’ and ‘Emotional Functioning’, and more symptomatology in all symptom domains except ‘Pain'. Conclusion HR-QoL between patients at a median of 4.4 years after esophagectomy for cancer did not differ. Differences were neither significant nor clinically relevant and furthermore, no differences were observed in subgroup analysis for severity of postoperative complications according to Clavien-Dindo.