Upper Gastrointestinal Research, Department of Molecular Medicine and Surgery, Norra Stationsgatan 67, Karolinska Institutet, Stockholm, Sweden.
Eur J Cancer. 2011 Mar;47(4):530-5. doi: 10.1016/j.ejca.2010.10.014. Epub 2010 Nov 11.
Patients treated with curatively intended surgery for oesophageal cancer have an approximately 30% chance of 5-year survival. Little is known about associations between postoperative health-related quality of life (HRQL) and long-term survival.
Poor postoperative HRQL after curatively intended oesophageal cancer surgery is associated with a reduced long-term survival.
A Swedish nationwide cohort of oesophageal cancer patients, treated surgically between 2001 and 2005, was followed up until death or end of August 2009. Nine HRQL aspects were selected for analyses from EORTC QLQ-C30 and QLQ-OES18 questionnaires answered 6 months postoperatively. The HRQL measures were categorised into two groups: 'good function' versus 'poor function' and 'no or minor symptoms' versus 'symptomatic'. Associations between HRQL and survival were analysed using Cox proportional hazard ratios (HR) and 95% confidence intervals (CIs), adjusted for potential confounding factors.
All 401 oesophageal cancer patients who survived at least 6 months postoperatively and responded to the questionnaires were included. For each of the nine selected outcomes, poor scores were associated with an increased hazard ratio of mortality: global HRQL (HR=1.55; 95% CI 1.19-2:02), physical function (HR=1.56; 95% CI 1.23-1.99), social function (HR=1.52; 95% CI 1.19-1.94), fatigue (HR=1.65; 95% CI 1.30-2.11), pain (HR=1.45; 95% CI 1.22-1.87), dyspnoea (HR=1.54; 95% CI 1.19-2.01), appetite loss (HR=1.69; 95% CI 1.32-2.14), dysphagia (HR=1.69; 95% CI 1.13-2.51) and oesophageal pain (HR=1.29; 95% CI 1.02-1.65).
HRQL assessed 6 months after oesophageal cancer surgery can be used as a clinically useful prognostic factor.
接受根治性手术治疗的食管癌患者，5 年生存率约为 30%。关于术后健康相关生活质量（HRQL）与长期生存之间的关系，我们知之甚少。
根治性食管癌手术后，患者的术后 HRQL 较差与长期生存降低有关。
对 2001 年至 2005 年间接受手术治疗的瑞典全国性食管癌患者队列进行随访，直至死亡或 2009 年 8 月底。从 EORTC QLQ-C30 和 QLQ-OES18 问卷中选择了 9 个与术后 HRQL 相关的方面进行分析，这些问卷是在术后 6 个月时回答的。HRQL 测量结果分为两组：“功能良好”与“功能不佳”和“无症状或症状轻微”与“症状明显”。使用 Cox 比例风险比（HR）和 95%置信区间（CI）分析 HRQL 与生存之间的关系，调整了潜在混杂因素的影响。
共纳入 401 例至少术后 6 个月存活并对问卷做出回应的食管癌患者。对于所选的 9 个结果中的每一个，较差的评分与死亡风险增加相关：总体 HRQL（HR=1.55；95%CI 1.19-2:02）、身体功能（HR=1.56；95%CI 1.23-1.99）、社会功能（HR=1.52；95%CI 1.19-1.94）、疲劳（HR=1.65；95%CI 1.30-2.11）、疼痛（HR=1.45；95%CI 1.22-1.87）、呼吸困难（HR=1.54；95%CI 1.19-2.01）、食欲下降（HR=1.69；95%CI 1.32-2.14）、吞咽困难（HR=1.69；95%CI 1.13-2.51）和食管疼痛（HR=1.29；95%CI 1.02-1.65）。
食管癌手术后 6 个月评估的 HRQL 可作为一种临床有用的预后因素。
