The Influence of Comorbidity on Health-Related Quality of Life After Esophageal Cancer Surgery

Backemar, Lovisa; Johar, Asif; Wikman, Anna; Zylstra, Janine; Gossage, James; Davies, Andrew; Lagergren, Jesper; Lagergren, Pernilla

doi:10.1245/s10434-020-08303-1

Cited by 6 publications

(6 citation statements)

References 32 publications

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“…In line with the findings of Backemar et al [30], we also identified a higher ASA score as an important predictor of lower overall health status and long-term QoL. Unlike other studies, we did not find an association between other risk factors such as neoadjuvant treatment and the presence of comorbidities with impaired QoL [23, 28, 30].…”

Section: Discussionsupporting

confidence: 91%

Quality of Life after Minimally Invasive Esophagectomy: A Cross-Sectional Study

et al. 2022

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Introduction: Surgery remains essential in the curative treatment of esophageal cancer (EC), but it is known for its high morbidity and impaired health-related QoL. Minimally invasive esophagectomy (MIE) was introduced to reduce surgical trauma and improve QoL. Methods: This cross-sectional study aimed to evaluate long-term HRQoL after MIE in comparison to the general population. HRQoL assessment was based on three questionnaires: the European Organisation for Research and Treatment of Cancer (EORTC) Core 30 (QLQ-C30, version 3), the EORTC QLQ Oesophago Gastric 25 (QLQ-OG25), and the Supportive Care Needs Survey-Short Form34 (SCNS-SF34). Results were compared to a healthy reference population. Results: One hundred and forty eligible MIE patients were identified, of whom met the inclusion criteria, and 49 completed all questionnaires. Patients reported a significantly better mean score on the global health status and QoL than the healthy reference population (71.5 ± 15.1 versus 66.1 ± 21.7; p=0.016). However, patients scored significantly worse about functioning (physical, role and social) (p<0.05), fatigue (p=0.021), eating, dysphagia, pain and discomfort, reflux, appetite loss, weight loss, coughing, and taste (p< 0.001). Discussion/Conclusion: EC survivors can reach a high global health status and QoL at least one year after MIE, despite long-term functional, nutritional and gastrointestinal complaints. Patients provided written informed consent, and the study protocol was approved by the ethics committee of Ghent University hospital (identifier: ID B670201940737).

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Section: Discussionsupporting

confidence: 91%

Quality of Life after Minimally Invasive Esophagectomy: A Cross-Sectional Study

et al. 2022

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“…21,[30][31][32][33] Various studies reported that older, co-morbid, and advanced-stage cancer patients had poor HRQoL. 15,[34][35][36][37] Hence, this high burden of poor HRQoL revealed in our study could be linked to the predominance of co-morbid and advanced-stage esophageal cancer patients in our setting. In sub-Saharan Africa, cancer care is suboptimal due to the shortage of diagnostic facilities and the high cost of treatment.…”

Section: Determinants Of Hrqol Among Gastrointestinal Cancer Patientsmentioning

confidence: 55%

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

Degu,

Karimi,

Opanga

et al. 2024

Cancer Reports

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BackgroundDespite the advancement of modern treatment approaches, several studies indicated a diminished health‐related quality of life (HRQoL) in patients with gastrointestinal cancer. However, there is insufficient data about the HRQoL of gastrointestinal cancer patients in Kenya.AimsThe study aimed to investigate HRQoL and its determinants in gastrointestinal cancer patients at Kenyatta National Hospital.MethodsA cross‐sectional study was employed among 160 esophageal, 103 gastric, and 96 colorectal cancer patients. The patient list, identified by unique hospital identification numbers, was obtained from records. Eligibility was assessed based on predetermined criteria, and the hospital identification numbers were reshuffled. Study participants were then randomly selected daily during the data collection period. Data were collected using a researcher‐administered European Organization for Research and Treatment of Cancer quality of life questionnaire. The data entry and analysis were carried out using Statistical Package for the Social Sciences 26.0 statistical software. A bivariate and multivariate binary logistic regression analysis was employed to investigate determinants of HRQoL at a 0.05 level of significance.ResultsMost esophageal (N = 118, 73.7%), gastric (N = 75, 72.8%), and colorectal (N = 72, 75%) cancer patients had poor overall HRQoL. In the social (p = .04) and cognitive (p = .02) domain of HRQoL, esophageal cancer patients had a significantly lower mean score as compared to gastric cancer patients. Colorectal cancer patients had the highest mean score in physical functioning (p = .01) as compared with gastric cancer patients. Nonetheless, gastric cancer patients had the highest mean score in emotional functioning domains of quality of life as compared to esophageal (p = .04) and colorectal (p < .001) cancer patients The study revealed a low mean HRQoL score in the majority of the symptom domains of quality of life. A statistically significant difference in all domains of HRQoL was not observed in various treatment modalities of gastrointestinal cancer. Advanced‐stage (stages III and IV) and co‐morbidities were significant determinants of poor HRQoL.ConclusionsThe overall HRQoL of gastrointestinal cancer patients was poor. Advanced‐stage cancer and co‐morbidities were significant determinants of poor HRQoL. Therefore, intensification of routine monitoring of the disease and the treatments should be actively implemented to improve the HRQoL.

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“…Adequate drainage after resection in these patients is particularly important to avoid clinical symptoms associated with perihepatic fluid collection, including fever and/or abdominal discomfort [42]. The Charlson Comorbidity Index (CCI) was developed to predict the prognosis of admitted patients by assessing the number of certain comorbidities and their severity and has been widely used to assess the degree of comorbidity burden [43,44]. The CCI system records some important comorbidity closely relevant in the context of elective liver surgery, including coexisting liver disease, chronic pulmonary disease, peptic ulcer disease, diabetes, moderate-tosevere renal disease and tumor.…”

Section: Plos Onementioning

confidence: 99%

Postoperative fever after liver resection: Incidence, risk factors, and characteristics associated with febrile infectious complication

et al. 2022

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Purpose To evaluate the incidence and risk factors of postoperative fever (POF) after liver resection. In patients with POF, predictors of febrile infectious complications were determined. Methods A total of 797 consecutive patients undergoing liver resection from January 2015 to December 2019 were retrospectively investigated. POF was defined as body temperature ≥ 38.0°C in the postoperative period. POF was characterized by time of first fever, the highest temperature, and frequency of fever. The Institut Mutualiste Montsouris (IMM) classification was used to stratify surgical difficulty, from grade I (low), grade II (intermediate) to grade III (high). Postoperative leukocytosis was defined as a 70% increase of white blood cell count from the preoperative value. Multivariate analysis was performed to identify risk factors for POF and predictors of febrile infectious complications. Results Overall, 401 patients (50.3%) developed POF. Of these, 10.5% had the time of first fever > postoperative day (POD) 2, 25.9% had fever > 38.6°C, and 60.6% had multiple fever spikes. In multivariate analysis, risk factors for POF were: IMM grade III resection (OR 1.572, p = 0.008), Charlson Comorbidity Index score > 3 (OR 1.872, p < 0.001), and serum albumin < 3.2 g/dL (OR 3.236, p = 0.023). 14.6% patients developed infectious complication, 21.9% of febrile patients and 7.1% of afebrile patients (p < 0.001). Predictors of febrile infectious complications were: fever > 38.6°C (OR 2.242, p = 0.003), time of first fever > POD2 (OR 6.002, p < 0.001), and multiple fever spikes (OR 2.039, p = 0.019). Sensitivity, specificity, positive predictive value and negative predictive value for fever > 38.6°C were 39.8%, 78.0%, 33.7% and 82.2%, respectively. A combination of fever > 38.6°C and leukocytosis provided high specificity of 95.2%. Conclusion In this study, we found that IMM classification, CCI score, and serum albumin level related with POF development in patients undergone liver resection. Time of first fever > POD2, fever > 38.6°C, and multiple fever spikes indicate an increased risk of febrile infectious complication. These findings may aid decision-making in patients with POF who require further diagnostic workup.

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The Influence of Comorbidity on Health-Related Quality of Life After Esophageal Cancer Surgery

Cited by 6 publications

References 32 publications

Quality of Life after Minimally Invasive Esophagectomy: A Cross-Sectional Study

Quality of Life after Minimally Invasive Esophagectomy: A Cross-Sectional Study

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

Postoperative fever after liver resection: Incidence, risk factors, and characteristics associated with febrile infectious complication

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