Djärv T, Lagergren J, Blazeby J M, Lagergren P
Unit of Oesophageal and Gastric Research, Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
Br J Surg. 2008 Sep;95(9):1121-6. doi: 10.1002/bjs.6293.
The aim of the study was to assess health-related quality of life (HRQL) in patients with surgically cured oesophageal cancer.
A Swedish nationwide cohort of patients undergoing oesophagectomy for cancer between April 2001 and January 2004 was studied prospectively, and compared with a Swedish age- and sex-adjusted reference population. Validated European Organisation for Research and Treatment of Cancer quality of life questionnaires were used to assess HRQL at 6 months and 3 years after surgery. A mean score difference of 10 or more between groups was considered clinically relevant and tested further for statistical significance.
Of 358 patients, 117 (32.7 per cent) survived for at least 3 years. Of these, 87 patients (74.4 per cent) responded to the questionnaires. Six months after surgery, most aspects of HRQL were substantially worse than in the reference population with no improvement at 3 years. Patients alive at 3 years reported significantly poorer role and social function, and significantly more problems with fatigue, diarrhoea, appetite loss, nausea and vomiting, than in the reference population.
HRQL in long-term survivors after oesophagectomy does not improve between 6 months and 3 years after surgery, and is worse than that in a comparable reference population.
本研究旨在评估手术治愈的食管癌患者的健康相关生活质量(HRQL)。
对2001年4月至2004年1月间在瑞典接受食管癌切除术的全国性队列患者进行前瞻性研究,并与瑞典年龄和性别调整后的参考人群进行比较。使用经过验证的欧洲癌症研究与治疗组织生活质量问卷在术后6个月和3年评估HRQL。两组之间平均得分差异10分或更多被认为具有临床相关性,并进一步进行统计学显著性检验。
358例患者中,117例(32.7%)存活至少3年。其中,87例患者(74.4%)对问卷做出了回应。术后6个月,HRQL的大多数方面比参考人群差得多,3年时无改善。存活3年的患者报告其角色和社会功能明显较差,疲劳、腹泻、食欲减退、恶心和呕吐问题也明显多于参考人群。
食管癌切除术后长期存活者的HRQL在术后6个月至3年之间没有改善,且比可比的参考人群差。