Initial Quality of Life (QOL) Deficit Is Related to Decreased Survival in Esophageal Cancer (EC): Final Report of 840 Consecutive Patients Prospectively Evaluated by the Single-Institutional Romero Registry

Abstract

Results: A total of 898 patients were included. At 2 years, we had data for over 94% of patients. At the early time point 54% of patients had a change in QOL summary that was a MDD or greater for bowel, 37% for urinary incontinence, 78% for urinary obstruction, and 42% for sexual function. At 2 years, a MDD was noted in 29%, 24%, 36%, and 47% for bowel, urinary incontinence, urinary obstruction, and sexual domains, respectively. For those with less than a MDD at the early time, the proportion with MDD at 2 years was 19%, 15%, 14%, and 31%. On MVA, after controlling for age, baseline QOL, PSA, Gleason score, T-stage, prostate volume, and RT technique, an early MDD was the strongest predictor of MDD at 2 years in all domains: OR Z 2.4 [95% CI Z 1.6-3.5] for bowel, OR Z 4.5 [95% CI Z 2.9-6.9] for urinary incontinence, OR Z 3.7 [95% CI Z 2.2-6.4] for urinary irritation, and OR Z 3.7 [95% CI Z 2.55.5] for sexual function. Conclusions: Early QOL decline was the strongest predictor of QOL impacts at 2 years in all domains across multiple RT treatment types. These data require external validation, but are suggestive that early QOL declines may be a viable surrogate for 2 year QOL in future studies. Author Disclosure: S. Zhao: None. J.R. Evans: None. S. DaignaultNewton: None. M.G. Sanda: None. J. Michalski: None. H.M. Sandler: None. D.A. Kuban: None. J.P. Ciezki: None. I.D. Kaplan: None. A.L. Zietman: None. F.Y. Feng: None. L. Hembroff: None. S. Suy: None. C.A. Mantz: A. Employee; 21st Century Oncology. S. Collins: G. Consultant; Accuray. D.A. Hamstra: None.