Abstract
BackgroundPopulation-based patient reported outcome data in oesophageal cancer are rare. The main purpose of this study was to describe health-related quality of life (HRQOL) 1 year after the diagnosis of oesophageal cancer, comparing subgroups of curatively and palliatively managed patients.MethodsThis is a nationwide population-based cohort study, based on the Swedish National Registry for Oesophageal and Gastric Cancer (NREV) with prospectively registered data, including HRQOL instruments from the European Organisation for Research and Treatment of Cancer including the core and disease specific questionnaires (EORTC QLQ-C30 and QLQ-OG25). Patients diagnosed with oesophageal cancer between 2009 and 2016 and with complete HRQOL data at 1 year follow-up were included. HRQOL of included patients was compared to a reference population matched by age and gender to to a previous cohort of unselected Swedish oesophageal cancer patients. Linear regression was performed to calculate mean scores with 95% confidence intervals (CI) and adjusted linear regression analysis was used to calculate mean score differences (MD) with 95% CI.ResultsA total of 1156 patients were included. Functions and global health/quality of life were lower in both the curative and palliative cohorts compared to the reference population. Both curatively and palliatively managed patients reported a severe symptom burden compared to the reference population. Patients who underwent surgery reported more problems with diarrhoea compared to those treated with definitive chemoradiotherapy (dCRT) (MD -14; 95% CI − 20 to − 8). Dysphagia was more common in patiens treated with dCRT compared to surgically treated patients (MD 11; 95% CI 4 to 18). Those with palliative intent due to advanced tumour stage reported more problems with dysphagia compared to those with palliative intent due to frailty (MD -18; 95% CI − 33 to − 3).ConclusionsOne year after diagnosis both curative and palliative intent patients reported low function scores and severe symptoms. Dysphagia, choking, and other eating related problems were more pronounced in palliatively managed patients and in the curative intent patients treated with dCRT.
Highlights
Oesophageal cancer is the seventh most common cancer and the sixth most common cause of cancer deaths worldwide [1]
Dysphagia, choking, and other eating related problems were more pronounced in palliatively managed patients and in the curative intent patients treated with definitive chemoradiotherapy (dCRT)
The findings of this study suggest that in patients with oesophageal cancer in general, but in particular those with a palliative management intention, attention needs to be focused on alleviating psychological distress, anxiety, and on treating dysphagia and other eating related problems, as well as recognition of altered physical and social roles
Summary
Oesophageal cancer is the seventh most common cancer and the sixth most common cause of cancer deaths worldwide [1]. Oesophageal cancer is a lethal disease, with approximately 70% of patients being managed with a palliative intention after initial staging. More than half of the patients initially managed curatively, eventually succumb to the disease [2]. Despite that the majority of patients diagnosed with oesophageal or gastro-oesophageal junctional (GOJ) carcinoma are managed with palliative intent, most of the data published regarding health-related quality of life (HRQOL) addresses curative treatment [3]. In ongoing and future trials HRQOL is an important outcome, ideally measured before, during and after treatments and in the evaluation of different clinical management pathways [3]. The main purpose of this study was to describe health-related quality of life (HRQOL) 1 year after the diagnosis of oesophageal cancer, comparing subgroups of curatively and palliatively managed patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
