Health-related quality of life in esophageal cancer: Effect of neoadjuvant chemoradiotherapy followed by surgical intervention

Abstract

Neoadjuvant therapy has a significant effect on health-related quality of life, but this is transient, with recovery to baseline within 5 to 7 weeks after completion of induction therapy. Health-related quality of life decreases again after surgical intervention but returns to baseline levels within 3 months.

Factors Relating to Quality of Life After Esophagectomy for Cancer Patients in Taiwan

“…4 Surgery can offer a 30% chance of cure in early-stage EC 5 and a 5-year overall survival rate of approximately 20% to 40%. 6,7 However, surgery for EC is associated with a high risk of severe complications in approximately 40% of patients, carries a risk of in-hospital death of up to 10%, and has a detrimental impact on quality of life (QoL). 8,9 Clearly, self-reported QoL information is important because it adds predictive value to the best available preoperative and postoperative prognosticators 10 and because it supplements informed decision making before surgery.…”

Quality of life assessment in esophagectomy patients

“…However, it returns back to baseline within 3 months. At one year, HRQOL continues to improve when compared to preoperative baseline (9). It is important to note that although global/overall HRQOL appears to return to baseline/pre-treatment levels, the physical functioning component of HRQOL still remains poorer or worse than baseline/pre-treatment levels (9).…”

“…It was found that higher baseline FACT-E or ECS were both independently associated with better survival. Thus, pre-treatment HRQOL measures appeared to provide prognostication even when one controls for stage and treatments given (9,16,34). ECS, with its focused and shorter number of questions, consistently showed a larger effect size and tighter confidence intervals than FACT-E.…”

“…This changed at the 6 months mark as HRQOL scores became comparable to baseline/pre-treatment levels. HRQOL continued to improve in surgical patients with time (9,39).…”

“…Multimodality therapy including esophagectomy is the standard of care in locally-advanced cancer (6). Five-year overall survival is reported to be in the range of 20-40% (7)(8)(9)(10). However, the procedure itself is complex and morbid with up to 10% postoperative mortality (6).…”