Abstract
PurposeTo assess whether higher dispositional optimism could predict better health-related quality of life (HRQL) after esophageal cancer surgery.MethodsThis Swedish nationwide longitudinal study included 192 patients who underwent esophagectomy for cancer. The exposure was dispositional optimism measured by the Life Orientation Test-Revised (LOT-R) at 1 year post-surgery. Patients were categorized into four subgroups (very low, moderately low, moderately high, and very high dispositional optimism) based on the quartile of the LOT-R sum score. The outcome was HRQL assessed by the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30) and Quality of Life Questionnaire-Esophago-Gastric module 25 (QLQ-OG25) at 1, 1.5, and 2 years post-surgery. Linear mixed-effects models, adjusted for potential confounders, were used to examine the mean score difference (MSD) with 95% confidence interval of HRQL among the four patient subgroups.ResultsPatients with very high dispositional optimism reported clinically relevantly better global quality of life, emotional function, and social function (MSD range 10–16) and less severe symptoms in pain, dyspnea, diarrhea, eating difficulty, anxiety, dry mouth, trouble with taste, worry about weight loss, and self-doubt about body image (MSD range − 9 to − 22) than patients with lower dispositional optimism. Patients with moderately high dispositional optimism reported clinically and statistically significantly better global quality of life (MSD 10) and less severe diarrhea (MSD − 9) than patients with lower dispositional optimism. Adjusted MSDs were constant over the three time points in all aspects except for eating difficulty.ConclusionsMeasuring dispositional optimism could help identify patients at higher risk of poor HRQL recovery after esophageal cancer surgery.
Highlights
To assess whether higher dispositional optimism could predict better health-related quality of life (HRQL) after esophageal cancer surgery
Patients with esophagectomy for cancer usually suffer from substantially decreased health-related quality of life (HRQL), especially within 6 months postsurgery.[2,3]
This study showed that, compared with patients with lower dispositional optimism, patients with higher dispositional optimism reported better HRQL at 1, 1.5, and 2 years after esophageal cancer surgery, in the aspects of global quality of life, emotional function, social function, anxiety, pain, and body image, which is in line with previous studies conducted among patients with other subtypes of cancer.[9,10,11,12,13,14,15]
Summary
To assess whether higher dispositional optimism could predict better health-related quality of life (HRQL) after esophageal cancer surgery. This Swedish nationwide longitudinal study included 192 patients who underwent esophagectomy for cancer. The exposure was dispositional optimism measured by the Life Orientation Test-Revised (LOT-R) at 1 year post-surgery. Patients were categorized into four subgroups (very low, moderately low, moderately high, and very high dispositional optimism) based on the quartile of the LOT-R sum score. The outcome was HRQL assessed by the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30) and Quality of Life Questionnaire-EsophagoGastric module 25 (QLQ-OG25) at 1, 1.5, and 2 years postsurgery. Linear mixed-effects models, adjusted for potential confounders, were used to examine the mean score difference (MSD) with 95% confidence interval of HRQL among the four patient subgroups
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