A prospective longitudinal study examining the quality of life of patients with esophageal carcinoma.

BACKGROUND

Quality of life (QL) measurement provides detailed information about outcome from the patient's perspective. This study assessed the impact on short and long term QL of esophagectomy and palliative treatment in patients with esophageal carcinoma.

METHODS

Consecutive patients undergoing potentially curative esophagectomy or purely palliative treatment completed the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and the dysphagia scale from the EORTC QLQ-OES24 before treatment and at regular intervals until death or for 3 postoperative years. Median scores were calculated for patients surviving more than 2 years after surgery (n = 17), for patients surviving less than 2 years after esophagectomy (n = 38), and for patients undergoing palliative treatment (n = 37).

RESULTS

Baseline functional and symptom QL scores were similar in both groups of patients undergoing esophagectomy, and these were better than scores from patients selected for palliative treatment. Six weeks after esophagectomy, patients reported worse functional, symptom, and global QL scores than before treatment. In patients who survived at least 2 years, QL scores returned to preoperative levels within 9 months, but patients who died within 2 years of surgery never regained their former QL. In both groups, dysphagia improved after surgery and the improvement was maintained until death or for the duration of the study. Patients undergoing palliative treatment reported gradual deterioration in most aspects of QL until death.

CONCLUSIONS

Esophagectomy has a negative impact on QL; this effect is transient for patients who survive for 2 or more years. This finding should be considered when selecting patients for surgery.