Health-related quality of life in patients with esophageal cancer or precancerous lesions assessed by EQ-5D: A multicenter cross-sectional study.

Youqing Wang,Jiansong Ren,Xiaojie Sun,Lingbin Du,Ying Ren,Wanqing Chen,Huizhang Li,Li Lan,Min Dai,Guoxiang Liu,Xiaohua Sun,Lin Zhu,Yuqin Liu,Huiyao Huang,Wenqiang Wei,Juan Zhu,Jiyong Gong,Xianzhen Liao,Yana Bai,Jufang Shi,Peian Lou,Ayan Mao,Bingbing Song,Xiaojing Xing,Shouling Wu,Xiao Qi,Jinyi Zhou,Le Wang,Qi Zhou,Jie He,Kai Zhang,Linh Mai

doi:10.1111/1759-7714.13368

Abstract

BackgroundWe aimed to obtain a set of health state utility scores of patients with esophageal cancer (EC) and precancerous lesions in China, and to explore the influencing factors of health‐related quality of life (HRQoL).MethodsA hospital‐based multicenter cross‐sectional study was conducted. From 2013 to 2014, patients with EC or precancerous lesions were enrolled. HRQoL was assessed using a European quality of life‐5 dimension (EQ‐5D‐3L) instrument. Multivariable linear regression analysis was performed to explore the influencing factors of the EQ‐5D utility scores.ResultsA total of 2090 EC patients and 156 precancer patients were included in the study. The dimension of pain/discomfort had the highest rate of self‐reported problems, 60.5% in EC and 51.3% in precancer patients. The mean visual analog scale (VAS) score for EC and precancer patients were 68.4 ± 0.7 and 64.5 ± 3.1, respectively. The EQ‐5D utility scores for EC and precancer patients were estimated as 0.748 ± 0.009 and 0.852 ± 0.022, and the scores of EC at stage I, stage II, stage III, and stage IV were 0.693 ± 0.031, 0.747 ± 0.014, 0.762 ± 0.015, and 0.750 ± 0.023, respectively. According to the multivariable analyses, the factors of region, occupation, household income in 2012, health care insurance type, pathological type, type of therapy, and time points of the survey were statistically associated with the EQ‐5D utility scores of EC patients.ConclusionsThere were remarkable decrements of utility scores among esophageal cancer patients, compared with precancer patients. The specific utility scores of EC would support further cost‐utility analysis in populations in China.

Highlights

Esophageal cancer (EC) is one of the most prevalent malignant tumors in the upper digestive system
Among 1920 patients with available pathological information, 1417 patients were diagnosed with squamous cell carcinoma and 142 patients were diagnosed with adenoma
Time points of the survey (Ref = in treatment). This current work is a unique large-scale multicenter study focusing on the health-related quality of life (HRQoL) of patients with esophageal cancer (EC) or precancerous lesions assessed by an internationally comparable and utility instrument, the European quality of life-5 dimension (EQ-5D) questionnaire

Summary

Introduction

Esophageal cancer (EC) is one of the most prevalent malignant tumors in the upper digestive system. With a mortality rate of 13.68 per 100 000 people, it has been ranked fourth as a leading cause of cancer death in 2015.2 The prognosis of EC is poor, with a five-year relative survival of 20.9% in China.[3]. The postoperative prognosis of patients with early EC is much better, with a five-year survival rate of ≥90% as reported in the study by Sadiq and Mansour.[4]. Previous studies have indicated that the incidence rates of EC have decreased in China over the last 20 years, but EC has still been a significant sociopsychological and economic burden for patients.[7]. We aimed to obtain a set of health state utility scores of patients with esophageal cancer (EC) and precancerous lesions in China, and to explore the influencing factors of health-related quality of life (HRQoL).

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