Health-related quality of life one year after the diagnosis of oesophageal cancer: a population-based study from the Swedish National Registry for Oesophageal and Gastric Cancer

Abstract

Background Population-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. Methods This 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. Results A 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). Conclusions One 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.

Tislelizumab versus chemotherapy as second-line treatment of advanced or metastatic esophageal squamous cell carcinoma (RATIONALE 302): impact on health-related quality of life

“…Individuals with esophageal squamous cell carcinoma (ESCC), worldwide the most common histological subtype of esophageal cancer, typically experience a severe symptom burden at diagnosis and associated reductions in health-related quality of life (HRQoL) due to esophageal obstruction throughout the course of their disease. 1 , 2 , 3 In addition, self-reported health status and ESCC-specific symptoms associated with HRQoL are predictive of overall survival (OS) in patients with potentially curable and advanced esophagogastric esophageal cancer, further underscoring the importance of these domains. 4 , 5 A better understanding of ESCC-specific symptoms, functioning, and associated HRQoL are especially needed for patients with advanced or metastatic ESCC given that second-line chemotherapy has limited efficacy with marginal antitumor activity, poor long-term survival, and significant toxicities.…”

Health‐related quality of life among patients with esophageal, gastric, and colorectal cancer at Kenyatta National Hospital

“…The mean HRQoL score of physical and cognitive functioning was higher in esophageal cancer patients, suggesting good HRQoL in these domains. In contrast, studies in Sweden revealed that esophageal cancer patients had poor HRQoL in their physical functioning 30,39 . However, esophageal cancer patients had suboptimal HRQoL in the role, emotional, global health, and social domains of HRQoL that might be related to psychological distress due to the diagnosis of cancer and its treatment‐related adverse drug reactions and future uncertainties.…”

“…In contrast, several studies showed poor HRQoL in the symptom scales among esophageal cancer patients. 30,39,40 These variations could be the possibility of having better symptomatic management care in our setting as a national referral facility.…”

“…In contrast, studies in Sweden revealed that esophageal cancer patients had poor HRQoL in their physical functioning. 30,39 However, esophageal cancer patients had suboptimal HRQoL in the role, emotional, global health, and social domains of HRQoL that might be related to psychological distress due to the T A B L E 4 Different domains of HRQoL scores according to the treatment modalities. diagnosis of cancer and its treatment-related adverse drug reactions and future uncertainties.…”

Neoadjuvant Chemoradiotherapy versus Chemotherapy for Gastroesophageal Junction Adenocarcinoma; Which Is the Optimal Treatment Option?

“…Cardiopulmonary toxicity and fibrosis, although minimized with modern radiation techniques, is an evolving process over several months post-treatment. In long-term follow-up of NeoRes patients, chronic cough and persistent impairment in overall health-related QoL, even 5 years after surgery, were significantly more frequent after RCT [ 31 ]. In the present study, we also observed a trend to a higher length stay and of ICU stay.…”