Changes in Health-Related Quality of Life of Patients Treated for Esophageal Cancer in Eldoret, Kenya

Abstract

Purpose: The study objectives were: to determine the demographic and clinical characteristics of patients treated for EC in Eldoret and to determine the change in health-related quality of life of patients treated for EC. Methodology: A longitudinal study was conducted at three cancer centers in Eldoret, Kenya. Participants were interviewed at enrollment (pre-treatment) and three months post-treatment. The study included patients aged 18 and above with histologically confirmed esophageal cancer. Consecutive sampling method was used to enroll study participants until a predetermined sample size of 59 was achieved. Independent variables considered were patient characteristics (demographic and clinical), and baseline HRQoL while the dependent variable was 3 months post-treatment HRQoL. Patients' characteristic data was analyzed using descriptive statistics (frequencies and percentages); change in HRQoL was calculated using the analysis of variance (ANOVA) test and the results were presented using tables. Findings: At baseline, 59 patients (68% female, mean age 56.3 years) were enrolled. The most common complaints were dysphagia (100%) and weight loss (74.6%). The baseline mean HRQoL score was 107.1, indicating a compromised quality of life at the start of treatment. After treatment, patients receiving chemotherapy plus surgery showed improved HRQoL, while radiotherapy alone was associated with deterioration. The differences were statistically significant (p-values: 0.04 and 0.0092, respectively). Multivariate regression revealed that only baseline HRQoL was significantly associated with post-treatment HRQoL (p=0.0065).This study sheds light on the underexplored aspect of HRQoL in Kenyan esophageal cancer patients. The findings emphasize the impact of treatment modalities on HRQoL, with chemotherapy plus surgery showing better outcomes. The study underscores the importance of considering patients' baseline HRQoL in assessing post-treatment outcomes. Addressing these factors can inform targeted interventions to improve the overall well-being of esophageal cancer patients in Kenya. Further research with larger, more diverse samples is warranted to enhance the generalizability of these findings. Unique Contribution to Theory Practice and Policy: This study highly recommends community sensitization and awareness of esophageal cancer to the at-risk population groups, further research on HRQoL as a prognostic marker for patients with esophageal cancer and more high-quality studies on HRQoL with large sample sizes are needed to determine the association between characteristics of the patients and health-related quality of life.