Life Of Esophageal Cancer Patients Research Articles

Small Cuts, Big Difference? The Impact of a Minimally Invasive Thoracic Phase during Ivor Lewis Esophagectomy on Long-Term Quality of Life of Esophageal Cancer Patients

Abstract Background Due to improved survival of esophageal cancer patients, long-term quality of life (QoL) is increasingly gaining importance. We analyzed QoL of patients treated with open Ivor Lewis esophagectomy (Open-E) or a hybrid operation including laparotomy and a robot-assisted thoracic phase (hRob-E), as well as a standard group of healthy individuals. Aims The aim of this study is to evaluate the impact of a minimally invasive compared to an open approach during the thoracic phase of Ivor Lewis esophagectomies on quality of life. Methods With a median follow-up of 36 months after hRob-E (n=28) and 40 months after Open-E (n=43), patients' QoL was assessed using the European Organization for Research and Treatment of Cancer (EORTC) QoL Questionnaire Core 30 (QLQ-C30) and the EORTC Esophagus specific QoL questionnaire 18 (QLQ-OES18). Results Patients showed similar clinical-histological characteristics, yet hRob-E patients had significantly higher ASA scores at surgery (p<0.001). Patients and healthy controls reported similar global health status, emotional and cognitive functions. All of the surgically treated cancer patients reported reduced role and social functioning, fatigue, nausea and vomiting, dyspnea and diarrhea. However, physical functioning of Open-E patients was significantly reduced compared to healthy controls (p=0.019). In addition, a trend towards a better pain score after hRob-E compared to Open-E emerged (p=0.063). Regarding QLQ-OES18, hRob-E and Open-E treated patients similarly reported eating problems, reflux, and troubles swallowing saliva. Conclusion The general health status is not impaired after esophagectomy. Despite higher ASA scores, QoL of hRob-E patients is similar to that of patients operated with Open-E. Moreover, patients after hRob-E appear to have a better score regarding physical functioning and a better pain profile than patients after Open-E, indicating a benefit of a minimally invasive approach during the thoracic phase.

Symptom clusters and impact on quality of life in esophageal cancer patients

BackgroundEsophageal cancer patients can experience co-occurring, related symptoms labeled symptom clusters. This study aimed to identify symptom clusters and explore which SCs independently affect the quality of life (QoL) among esophageal cancer patients.MethodsThis cross-sectional study was performed in Shenyang, China, from February 2021 to February 2022. Finally, 118 esophageal cancer patients effectively completed the survey. Questionnaires’ information included the Functional Assessment of Cancer Therapy-General (FACT-G), the MD Anderson Symptom Inventory Gastrointestinal Cancer Module (MDASI-GI), the Multidimensions Scale of Perceived Social Support, and demographic and clinical characteristics. Exploratory factor analysis with principal axis factoring was used to identify symptom clusters, and multiple regression analysis was employed to analyze the influencing factors of QoL.ResultsThe mean score of FACT-G was 69.88 (SD = 17.85) among 118 esophageal cancer patients. Four symptom clusters were identified: psychological-somatic, dysphagia, fatigue-pain, and gastrointestinal symptom clusters. Results of regression analysis indicated a significant impact on QoL for chemotherapy (β = 0.140, P < 0.045), psychological-somatic symptom cluster (β = − 0.329, P = 0.013), and social support (β = 0.409, P < 0.001) after adjusting demographic and clinical characteristics. The linear combination explained 47.8% of the variance in QoL.ConclusionsThere is a critical need to emphasize the importance of psychological-somatic symptoms clusters management programs and increasing social support to improve QoL in esophageal cancer patients.

Effect of a pre-operative web-based dietary self-management intervention on patient satisfaction, body weight and quality of life of esophageal cancer patients: A prospective, observational study

PurposeThe purpose of this study was to investigate the adoption and actual use of a digital dietary monitoring system (DDMS) and its impact on patient satisfaction with the provided hospital care, body weight changes and health-related quality of life (HRQoL) in patients with potentially curable esophageal cancer planned for surgery. The DDMS enables patients and dietitians to monitor patients' nutritional intake and body weight during the preoperative period.MethodsIn this prospective observational study, the first 47 included patients received usual nutritional care, and were followed from diagnosis until surgery. After implementation of the DDMS 37 patients were followed, again from diagnosis until surgery. Main outcomes were actual use of the DDMS, by means of adoption and usage measures, overall patient satisfaction (EORTC-INPATSAT32), weight change and HRQoL (EORTC QLQ-C30 and EORTC-OG25). Outcomes were assessed immediately after diagnosis, and 6 and 12 weeks later.ResultsThe system had an adoption rate of 64% and a usage rate of 78%. No significant effects on patient satisfaction were found at 12 weeks after diagnosis between the intervention and the usual care group. The implementation of the DDMS also had no significant effect on body weight and HRQoL over time.ConclusionsPatients with potentially curable esophageal cancer planned for surgery were able to use the DDMS. However, no significant effects on patient satisfaction, body weight changes and HRQoL were observed. Further research should focus on the specific needs of patients regarding information and support to preoperatively optimize nutritional intake and nutritional status. The purpose of this study was to investigate the adoption and actual use of a digital dietary monitoring system (DDMS) and its impact on patient satisfaction with the provided hospital care, body weight changes and health-related quality of life (HRQoL) in patients with potentially curable esophageal cancer planned for surgery. The DDMS enables patients and dietitians to monitor patients' nutritional intake and body weight during the preoperative period. In this prospective observational study, the first 47 included patients received usual nutritional care, and were followed from diagnosis until surgery. After implementation of the DDMS 37 patients were followed, again from diagnosis until surgery. Main outcomes were actual use of the DDMS, by means of adoption and usage measures, overall patient satisfaction (EORTC-INPATSAT32), weight change and HRQoL (EORTC QLQ-C30 and EORTC-OG25). Outcomes were assessed immediately after diagnosis, and 6 and 12 weeks later. The system had an adoption rate of 64% and a usage rate of 78%. No significant effects on patient satisfaction were found at 12 weeks after diagnosis between the intervention and the usual care group. The implementation of the DDMS also had no significant effect on body weight and HRQoL over time. Patients with potentially curable esophageal cancer planned for surgery were able to use the DDMS. However, no significant effects on patient satisfaction, body weight changes and HRQoL were observed. Further research should focus on the specific needs of patients regarding information and support to preoperatively optimize nutritional intake and nutritional status.

Quality of life and influencing factors of postoperative accelerated rehabilitation of esophageal cancer patients

Objective: To explore the quality of life and its influencing factors of enhanced recovery after surgery (ERAS) of esophageal cancer patients. Methods: The quality of life of 134 esophageal cancer patients was assessed using the quality of life assessment scale (EORTC QLQ-C30) developed by the European Cancer Research and Treatment Organization. Student's t test, One-way ANOVA and multiple linear regression statistical methods were used to analyze the effects of sociodemographic and clinical characteristics on patients' quality of life. Results: The overall score of quality of life (74.00) was lower than that of the general population (75.30). However, the scores of emotion and cognition in function dimension (93.97 and 95.77) were better than those of the general population (82.80 and 86.50). The results of fatigue, pain, insomnia and constipation in symptom dimension (14.18, 10.94, 11.69 and 5.72) were better than those of the general population (28.80, 20.50, 20.40 and 10.70). The pathological stage, body mass index and dietary were independent influencing factors for the quality of life of patients with esophageal cancer (P<0.05). Conclusions: ERAS can partially improve the quality of life of esophageal cancer patients. More attention should be paid to the esophageal cancer patients after surgery and take targeted measures to improve their quality of life.

A systematic review on quality of life of esophageal cancer patients in China

Objective: To systematically review the quality of life of esophageal cancer patients in China. Methods: Based on CNKI, Wanfang, PubMed and EMbase database, related articles published from January 2009 to August 2019 were systematically retrieved. We extracted the basic information, synthesized and summarized related instruments evaluation results. Results: A total of 127 studies were included (121 in Chinese, 6 in English), involving 26 provinces, of which 79 studies were published in the past 5 years and only 4 studies were multicenter study. More than half of included studies had a sample size of <150 cases (72 studies). Most studies were from the medical care and nursing field (58 studies) and were about the evaluation and comparison of treatments and medicine (40 studies). Six specific tools, including most commonly used Core Quality of Life Questionnaire (QLQ-C30) reported in 74 studies, 4 generic instruments, including most commonly used 36-item Short Form Health Survey (SF-36) reported in 17 studies and several self-designed questionnaires, were used. All the instruments focused on physical, physiological and social dimensions, but the specific contents and numbers of items were different. The index of quality of life used were dimension scores and total scores, and only 2 studies were about the health-related utility of esophageal cancer patients. Conclusions: In China, the research on the quality of life of esophageal cancer patients increased rapidly over the past decade, but most were single-center and small sample studies. The esophageal cancer-specific QLQ-C30 and generic SF-36 were the most commonly used instruments in the studies. The medical care and nursing and evaluation of treatments were the main concerns, but the research on health utility scores of esophageal cancer was still limited in China.

Efficacy of Chemoradiotherapy on Health-Related Quality of Life in Esophageal Cancer Patients with Dysphagia

Introduction:Anogenital area is a small compartment in the human body. Recognition of various dermatological conditions affecting this area in children is essential for any physician involved in pediatric examination and evaluation.Aim:To assess the nature, diagnoses, and gender differences of Anogenital lesions in pediatric patients presented to Royal Medical Services (RMS) general dermatology clinics, who were five year old and younger.Methods:The authors reviewed patients’ medical records in the period between September 2015 and September 2018. The inclusion criteria were children of both genders who were five year old or younger and presented with papular lesions in the Anogenital area. Those patients visited the general dermatology clinics of The Royal Medical Services Hospitals from the Eastern and Southern regions of Jordan.Results:Over a period of 3 years, a total of 514 patients were five year old or younger presented with various Anogenital papular lesions were evaluated and treated in general dermatology clinics. 35% of the patients presented with Perianal Psuedoverrucous Papules and nodules, 21% presented with Anogenital warts, 16% presented with Molluscum Contageosum. Moreover, 10% were presented with Epidermal nevi, 6% presented with Pearly Penile Papules, 7% presented with Infantile Perineal Pyramidal Protrusion, 4% presented with Vulvar Vestibular Papillomatosis, 0.2% presented with Juvenile Xanthogranuloma, 0.2% presented with lymphangioma Circumscriptum, and 0.2% presented with median raphe cyst. In addition, gender differences were noticed among Genital Warts, Mollascum Contageosum, Pearly Penile Papules, and Vulvar Vestibular Papillomatosis.Conclusion:Anogenital papules in children have variable clinical presentations and can be caused by multiple number of infectious and non-infectious factors. The presence of such lesions can be a source of a major concern for parents, and might be mistakenly assumed as a result of sexual assaults. Proper recognition of these papules is of paramount importance for all physicians involved in children examination, to appropriately reassure parents and avoid unnecessary investigations and psychological distress.

Factors Affecting the Quality of Life in Esophageal Cancer Patients

Factors Affecting the Quality of Life in Esophageal Cancer Patients

Efficacy of Chemoradiotherapy on Health-Related Quality of Life in Esophageal Cancer Patients with Dysphagia.

Introduction:Esophageal cancer is diagnosed with more than 480,000 patients per year and this disease became the eighth most common cancer worldwide.Aim:In this study, we tried to investigate the role of chemoradiotherapy in decreasing the severity of dysphagia and increasing the quality of life (QOL) in patients with esophageal cancer.Methods:Patients were diagnosed with esophageal cancer, which were proven by pathological studies. Also, all of these patients had no primary surgeries for their esophageal cancer. For determining the cancer staging, the endoscopy, sonography, abdominal and pelvic computed tomography scans were assessed.Results:In this study, 81% of patients showed responsiveness to the chemoradiotherapy and their dysphagia significantly was getting improved after treatment in comparison to the initial date (P<0.01). Also, the pain score significantly decreased after chemoradiotherapy. However, the analysis failed to show any significant difference between before and after treatment in 19% of patients who had high degrees of dysphagia and they were the candidate for surgery and stent putting. On the other hand, we demonstrated that there is no correlation between sex, age, tumor type and location with the recovery rate of dysphagia. In addition, we showed that none of the patients showed the recurrence of dysphagia during the study (1.5 years).Conclusion:Chemoradiotherapy could be a novel treatment for patients with inoperable esophageal cancer to reduce the severity of dysphagia and increasing the QOL of these individuals.

Health-related quality of life of esophageal cancer patients in daily life after treatment: A multicenter cross-sectional study in China.

BackgroundThe improvement of diagnostic and therapeutic techniques has prolonged the survival time of patients with esophageal cancer. Little is known, however, about their health‐related quality of life (HRQoL) in daily life after treatment.MethodsEsophageal cancer patients who had been discharged from hospitals more than one year and healthy controls identified by screening were recruited from seven study centers covering eastern, central, and western regions of China. Patients were categorized into severe dysplasia/carcinoma in situ and stages I, II, III, and IV cancer, respectively. The EQ‐5D was employed to assess HRQoL. Multivariate regression analyses were conducted.ResultsA total of 1456 patients and 2179 controls were recruited. After adjusting for potential confounding factors, the likelihood of reporting problems in the five dimensions of patients was 3.8 to 23.1 times higher than controls, whilst the mean EQ‐5D utility score was 0.311 (95% CI, 0.276‐0.346) lower than controls. The mean utility scores of each patient subgroup were 0.158, 0.289, 0.303, 0.296, and 0.505 (95% CIs: 0.108‐0.208, 0.243‐0.336, 0.261‐0.346, 0.244‐0.347, and 0.437‐0.573) lower than controls, respectively. Patients had the greatest impairment in the self‐care dimension compared with controls, followed by the usual activities dimension. Therapeutic regimen, duration of illness, other chronic disease status, age, and marital status also had significant impact on different aspects of HRQoL in patients.ConclusionsEsophageal cancer significantly impaired patients' HRQoL in daily life after treatment. Advanced cancer stages were associated with larger decrements on health state utility. Utility scores reported here can facilitate further cost‐utility analyses.

Physical ExeRcise Following Esophageal Cancer Treatment (PERFECT) study: design of a randomized controlled trial

BackgroundFollowing esophagectomy, esophageal cancer patients experience a clinically relevant deterioration of health-related quality of life, both on the short- and long-term. With the currently growing number of esophageal cancer survivors, the burden of disease- and treatment-related complaints and symptoms becomes more relevant. This emphasizes the need for interventions aimed at improving quality of life. Beneficial effects of post-operative physical exercise have been reported in several cancer types, but so far comparable evidence in esophageal cancer patients is lacking. The aim of this study is to investigate effects of physical exercise on health-related quality of life in esophageal cancer patients following surgery.MethodsThe Physical ExeRcise Following Esophageal Cancer Treatment (PERFECT) study is a multicenter randomized controlled trial including 150 esophageal cancer patients after surgery with curative intent. Patients are randomly allocated to an exercise group or usual care group. The exercise group participates in a 12-week combined aerobic and resistance exercise program, supervised by a physiotherapist near the patient’s home-address. In addition, participants in the exercise group are requested to be physically active for at least 30 min per day, every day of the week. Participants allocated to the usual care group are asked to maintain their habitual physical activity pattern. The primary outcome is health-related quality of life (EORTC-QLQ-C30). Secondary outcomes include esophageal cancer specific quality of life, fatigue, anxiety and depression, sleep quality, work-related factors, cardiorespiratory fitness (VO2peak), muscle strength, physical activity, malnutrition risk, anthropometry, blood markers, recurrence of disease and survival. All questionnaire outcomes, diaries and accelerometers are assessed at baseline, post-intervention (12 weeks post-baseline) and 24 weeks post-baseline. Physical fitness, anthropometry and blood markers are assessed at baseline and post-intervention. In addition, adherence and safety are monitored throughout the exercise program.DiscussionThis randomized controlled trial investigates effects of physical exercise versus usual care in esophageal cancer patients after surgery. As the design of the exercise program closely resembles daily practice, this study can contribute both to evidence on effects of exercise in esophageal cancer patients, and to potential implementation strategies.Trial registrationTrial registration:Netherlands Trial Registry NTR5045Date of trial registration: January 19th, 2015Date and version study protocol: February 2017, version 1

EORTC QLQ-OES 18 module strategy for assessment of quality of life in esophageal cancer patients

EORTC QLQ-OES 18 module strategy for assessment of quality of life in esophageal cancer patients

Changes in exercise capacity, muscle strength, and health-related quality of life in esophageal cancer patients undergoing esophagectomy.

BackgroundSurgery for cancer of the thoracic esophagus is a challenging procedure associated with high morbidity and mortality. Perioperative rehabilitation has been introduced to promote early mobilization of the patients and to prevent postoperative pulmonary complications. The purpose of the present study was to characterize the preoperative functional exercise capacity, muscle strength, anxiety, depression, and health-related quality of life (QOL) in patients with esophageal cancer, and to evaluate the impact of radical esophagectomy on these parameters.MethodsWe performed a retrospective review of 34 consecutive patients with newly diagnosed resectable esophageal cancer who underwent esophagectomy followed by postoperative rehabilitation from January to December 2014. Patients were tested for 6-min walk distance (6MWD), knee-extensor muscle strength, hand grip strength, the Hospital Anxiety and Depression Scale (HADS), and the chronic obstructive pulmonary disease (COPD) assessment test (CAT) before and two weeks after the surgery. Before surgery, the pulmonary function test, and components of the MOS 36-item Short-Form Health Survey (SF-36) Questionnaire for general health were assessed.ResultsThe mean age was 67.3 ± 8.1 years. The patients were predominantly male (76.4 %), had high rates of smoking history (91.2 %), and squamous cell carcinoma (97.1 %). The predicted value for forced expiratory volume in 1 s was 94.0 ± 15.9 %, and 12 patients (35.3 %) had COPD. The clinical stage was 0-I in 12 patients, II in 4 patients, III in 16 patients, and IV in 2 patients. Thirty-one patients (91.2 %) underwent open surgery. At the baseline, components of the SF-36 scores significantly correlated with CAT and HADS scores, and the physical status was significantly poorer in patients with COPD than those without. Comparisons between the preoperative and postoperative values revealed significant decreases in 6MWD, hand grip strength, isometric knee extensor muscle strength, and a significant increase in CAT scores but not in HADS scores after surgery. In multiple regression analysis, decreases in 6MWD after the surgery significantly correlated with the preoperative physical component summary of SF-36.ConclusionsOur results indicate that surgery remained detrimental to health outcomes at two weeks. Further research should investigate whether prehabilitation would improve the postoperative outcomes, QOL, and physical fitness.Electronic supplementary materialThe online version of this article (doi:10.1186/s13102-016-0060-y) contains supplementary material, which is available to authorized users.

The effect of comprehensive intervention on the quality of life of esophageal cancer patients treated with radiotherapy

Objective To discuss the effect of comprehensive intervention on the quality of life of esophageal cancer patients receiving radiotherapy. Methods 100 patients with esophageal carcinoma treated with radiotherapy for the first timewere selected between October 2012 and December 2014 in Nantong Tumor Hospital in Jiangsu Province and randomly divided into control group and observation group(n=50 in each group) with a random number table. In the control group, routine dietary instruction, fluid infusion support and symptomatic intervention were used; comprehensive intervention was added in the observation group.Scores of core quality of life questionnaire (QLQ-C30) and nutritional indexesbefore and after radiotherapy in the two groups were compared. Results There were no statistically significant differences in QLQ-C30 scores and nutritional indexes between the two groups before radiotherapy (all P>0.05). After radiotherapy, the physical [(75.6±13.1)vs. (63.8±12.4)]and emotional function[(61.9±14.3) vs. (52.5±13.7)], fatigue[(36.6±13.2) vs. (45.8±15.0)], pain[(34.8±16.1) vs. (44.3±17.0)], insomnia[(49.2±15.7) vs. (57.2±14.3)], loss of appetite[(50.2±16.2) vs. (59.0±15.8)], nausea and vomiting [(21.5±10.3) vs. (29.9±11.3)], general health status[(68.8±13.4) vs. (58.2±12.8)] inthe observation group were significantly better than in the control group (all P<0.05). Innutritional status, body weight[(59.3±8.5)kg vs. (54.4±7.3)kg], body mass index[(21.9±2.1)kg/m2vs. (18.4±2.8)kg/m2], hemoglobin[(125.9±8.9)g/L vs. (107.3±9.5)g/L], albumin[(35.1±6.9)g/L vs.(29.0±5.3)g/L], and prealbumin[(213.54±37.47)mg/L vs. (174.56±36.26)mg/L]in the observation group were all higher than thosein the control group after radiotherapy (all P<0.01). Conclusion Comprehensive intervention for esophageal cancer patients receiving radiotherapymay improve nutritional status, reduce esophagitis, thirsty, fatigue, loss of appetite and other symptoms, improve the quality of life, ensure the completion of radiotherapy. Key words: Esophageal neoplasms; Radiotherapy; Esophagitis; Quality of life; Comprehensive intervention

Influences of transitional care on early quality of life in esophageal cancer patients after surgery

Objective To investigate the influences of transitional care on early quality of life in esophageal cancer patients after surgery. Methods A total of 195 patients with esophageal cancer were randomly divided into control group (98 cases, regular follow-up) and observation group (97 cases, transitional care) according to random number table. And then, the readmission rate of 2 months post discharge was compared in patients between two groups. Besides, quality of life of patients was evaluated with the quality of life questionnaire core 30 (QLQ-C30) at discharge and 2 months after intervention. Results The readmission rate of 2 months post-discharge of observation group and control group were 5.2%, 16.3% with a significant difference (χ2=6.332, P=0.012). There were no statistically significant differences in the scores of functional items and symptom items of QLQ-C30 (P>0.05). After the interventions, the scores of general health, emotional function and social function in observation group were higher than those in control group; the scores of fatigue, pain, insomnia, difficult breathing, loss of appetite in observation group were lower than those in control group; there were statistically significant differences between two groups (P<0.05). Conclusions Transitional care can provide positive guidance for living condition of patients with esophageal cancer, improve patients′ living condition so as to improve patients′ early quality of life. Key words: Esophageal neoplasms; Quality of life; Transitional care

Effect of different ways of oxygen inhalation on postoperative hypoxemia and quality of life in esophageal cancer patients

Effect of different ways of oxygen inhalation on postoperative hypoxemia and quality of life in esophageal cancer patients

Effect of quality feedback theory based nursing on cancer related fatigue and quality of life in esophageal cancer patients receiving adjuvant chemotherapy

Effect of quality feedback theory based nursing on cancer related fatigue and quality of life in esophageal cancer patients receiving adjuvant chemotherapy

Impact of bundle of nutritional interventions on esophageal cancer patients of life quality and nutrition status with concurrent radio-chemotherapy

Objective To discuss the impact of bundles of nutritional nursing interventions on nutritional status and quality of life of esophageal cancer patients who underwent concurrent radiotherapy and chemotherapy. Methods We selected eighty esophageal cancer patients admitted to our department for concurrent radio-chemotherapy during July 2012 to June 2014. We divided them into experimental and control group according to random number table, and each of forty cases. After a course of treatment, hemoglobin (Hb), serum albumin (ALB), serum pre-albumin (PA), total lymphocyte count (TLC)and the score of QLQ-C3.0 were compared between two groups. Results When patients admitted hospital, there were no statistical differences in index of the patients between two groups (P>0.05). After one course of treatment, the data of Hb(110.0±6.1) g/L, ALB(30.8±5.4)g/L, PA(181.6±58.4)mg/L, TLC(2.8±0.4)×109/L, score of whole healthy status (55.6±10.2) in the experimental group which were higher than those in the control group (t=2.484 2, 3.272 2, 3.255 5, 9.877 7, 5.527 5, respectively; P<0.05). Conclusions Bundle of nutrition interventions can significantly improve the nutritional status and the quality of life of esophageal cancer patients who underwent concurrent radio-chemotherapy, and it is worthy to promote. Key words: Esophageal cancer; Radiotherapy; Chemotherapy; Quality of life; Bundle of nutritional intervention

Research in correlation between quality of life and symptom distress of esophageal cancer patients undergoing postoperative chemotherapy

Objective To describe the quality of life and symptom distress in esophageal cancer patients undergoing postoperative adjuvant chemotherapy,and explore the influence of symptom distress on quality of life.Methods The Functional Assessment of Cancer Therapy-General (FACT-G),M.D.Anderson Symptom Inventory (MDASI) and demographic questionnaire were used to measure eighty-four patients undergoing postoperative adjuvant chemotherapy.Results The total average score of quality of life in patients undergoing chemotherapy after radical esophagectomy was (65.95±13.76) points.There was a significanfly negative relationship between the symptom distress and the severity of symptom and quality of life.Analysis of multiple factors showed that education level and symptom distress were the included variables in the multiple regression equation of quality of life,and the R2 was 0.253.Conclusions Quality of life in esophageal cancer patients undergoing postoperative adjuvant chemotherapy is influenced by many factors.The nurses should take measures to manage the symptom of patients and improve the quality of life of the patients. Key words: Eesophageal neoplasm; Radical esophagectomy; Chemotherapy; Quality of life; Symptom

Evaluating the health-related quality of life of esophageal cancer patients

The current norm of esophageal treatment includes any combination of surgery, chemotherapy and radiation therapy. The effectiveness of medical intervention has been predominantly assessed by morbidity, mortality and disease-free survival in the past. As patients' life expectancies lengthened from advances in treatment modalities, recent movements have shifted to acknowledge patients' health-related quality of life as an important outcome measure. The general trend for the use of multimodal treatments of esophageal cancer indicates an initial degradation of many aspects of HRQoL; however, without postoperative recovery delay related to neoadjuvant treatment. Several recent studies aimed to define aspects of HRQoL as prognostic indicators of esophageal cancer patients that may influence survival. It is imperative for practicing physicians to discuss these concepts with patients as they may cope with treatment complications more favorably if they are informed.

Health-related quality of life in long-term survivors after high-dose chemoradiotherapy followed by surgery in esophageal cancer

Curative treatment of esophageal cancer with definitive or preoperative high-dose chemoradiotherapy inflicts a major strain on the patients with potentially severe physical, emotional, and social consequences. The aim of this study was to assess various aspects of quality of life and fatigue in long-term survivors following such a treatment. Patients undergoing a potentially curative treatment between 1996 and 2007, and still alive (n= 41) completed quality of life questionnaires of the European Organization for Research and Treatment of Cancer core questionnaire (QLQ-C30) and esophageal cancer module (QLQ-OES18). Twenty patients were treated by surgery alone, and 21 patients were scheduled for high-dose chemoradiotherapy followed by surgery. Five of those patients did not undergo planned surgery. Preoperative chemoradiotherapy consisted of three courses of chemotherapy, cisplatin 100 mg/m(2) and 5-fluorouracil 5000 mg/m(2) in each course and concomitant radiotherapy of a median dose 66 Gy. Quality of life in esophageal cancer patients receiving high-dose chemoradiotherapy was compared with that for esophageal cancer patients who received only surgery, head and neck cancer patients, laryngectomized patients, and a random sample of the general Norwegian population. Esophageal cancer patients treated by high-dose chemoradiotherapy had significantly worse global quality of life as reflected by almost all functional scales and higher fatigue compared with esophageal cancer patients who received surgery alone, head and neck cancer patients, and the general Norwegian population. There were no significant differences in quality of life between the esophageal cancer patients receiving high-dose chemoradiotherapy and the laryngectomy patients. Further, the esophageal cancer patients receiving high-dose chemoradiotherapy had higher intensity of other symptoms like general pain, insomnia, nausea/vomiting, diarrhea, and constipation compared with the esophageal cancer patients who received surgery alone, head and neck cancer patients, and the general Norwegian population. High-dose chemoradiotherapy with cisplatin and 5-fluorouracil had a considerable negative long-term effect on global quality of life in patients with resectable esophageal cancer. Fatigue was a prominent long-lasting symptom in these patients.