Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Eur J Cancer Care (Engl). 2013 May;22(3):308-13. doi: 10.1111/ecc.12030. Epub 2012 Dec 18.
Although several studies have reported the impact of oesophagectomy on health-related quality of life (HRQOL), none has objectively assessed its impact on physical fitness. This study aimed to evaluate the impact of oesophagectomy on physical fitness and HRQOL in patients with oesophageal cancer. In this prospective study, we investigated 30 consecutive patients with newly diagnosed resectable oesophageal cancer who were scheduled to receive either neoadjuvant chemotherapy followed by surgery or surgery alone. The primary end-points were change from baseline in two measures of physical fitness (knee-extensor muscle strength and 6-min walking distance) after oesophagectomy. The secondary end-point was change from baseline in HRQOL measured with the European Organization for the Research and Treatment of Cancer Quality of Life Core Questionnaire with 30 items (EORTC QLQ-C30). Physical fitness was significantly lower after oesophagectomy than before oesophagectomy (P < 0.001). With regard to HRQOL, there was a significant pre- to post-oesophagectomy change in most of the scales. In the multiple regression analysis, the change in 6-min walking distance was the only significant variable affecting the change in physical functional score on the EORTC QLQ-C30 (P = 0.032). In conclusion, oesophagectomy adversely affects physical fitness and HRQOL in patients with oesophageal cancer. Six-minute walking distance may be a good indicator of HRQOL shortly after oesophagectomy.
尽管已有多项研究报道了食管癌切除术对健康相关生活质量(HRQOL)的影响,但尚无研究客观评估其对身体适应性的影响。本研究旨在评估食管癌切除术对食管癌患者身体适应性和 HRQOL 的影响。在这项前瞻性研究中,我们调查了 30 例连续诊断为可切除食管癌的患者,这些患者计划接受新辅助化疗加手术或单独手术。主要终点是食管癌切除术后两种身体适应性测量指标(膝关节伸肌肌力和 6 分钟步行距离)与基线相比的变化。次要终点是欧洲癌症研究与治疗组织(EORTC)生活质量核心问卷 30 项(EORTC QLQ-C30)测量的 HRQOL 与基线相比的变化。食管癌切除术后身体适应性明显低于术前(P < 0.001)。关于 HRQOL,大多数量表在术前到术后都有显著变化。在多元回归分析中,6 分钟步行距离的变化是唯一显著影响 EORTC QLQ-C30 身体功能评分变化的变量(P = 0.032)。总之,食管癌切除术会对食管癌患者的身体适应性和 HRQOL 产生不利影响。6 分钟步行距离可能是食管癌术后短期 HRQOL 的良好指标。