Department Surgery and Cancer, Imperial College London, London, UK.
Division of Surgery, Department of Clinical Science Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.
Br J Surg. 2021 Sep 27;108(9):1090-1096. doi: 10.1093/bjs/znab124.
Data on the long-term symptom burden in patients surviving oesophageal cancer surgery are scarce. The aim of this study was to identify the most prevalent symptoms and their interactions with health-related quality of life.
This was a cross-sectional cohort study of patients who underwent oesophageal cancer surgery in 20 European centres between 2010 and 2016. Patients had to be disease-free for at least 1 year. They were asked to complete a 28-symptom questionnaire at a single time point, at least 1 year after surgery. Principal component analysis was used to assess for clustering and association of symptoms. Risk factors associated with the development of severe symptoms were identified by multivariable logistic regression models.
Of 1081 invited patients, 876 (81.0 per cent) responded. Symptoms in the preceding 6 months associated with previous surgery were experienced by 586 patients (66.9 per cent). The most common severe symptoms included reduced energy or activity tolerance (30.7 per cent), feeling of early fullness after eating (30.0 per cent), tiredness (28.7 per cent), and heartburn/acid or bile regurgitation (19.6 per cent). Clustering analysis showed that symptoms clustered into six domains: lethargy, musculoskeletal pain, dumping, lower gastrointestinal symptoms, regurgitation/reflux, and swallowing/conduit problems; the latter two were the most closely associated. Surgical approach, neoadjuvant therapy, patient age, and sex were factors associated with severe symptoms.
A long-term symptom burden is common after oesophageal cancer surgery.
关于生存的食管癌手术后患者长期症状负担的数据很少。本研究的目的是确定最常见的症状及其与健康相关的生活质量的相互作用。
这是一项在 2010 年至 2016 年间欧洲 20 个中心接受食管癌手术的患者的横断面队列研究。患者必须在手术后至少 1 年无疾病。他们被要求在手术后至少 1 年的一个时间点完成一个 28 个症状的问卷。主成分分析用于评估症状的聚类和关联。通过多变量逻辑回归模型确定与严重症状发展相关的危险因素。
在 1081 名受邀患者中，有 876 名（81.0%）作出回应。在过去 6 个月内与之前手术相关的症状有 586 名患者（66.9%）经历过。最常见的严重症状包括精力或活动耐力降低（30.7%）、进食后早饱感（30.0%）、疲劳（28.7%）和烧心/酸或胆汁反流（19.6%）。聚类分析显示，症状聚类为六个域：乏力、肌肉骨骼疼痛、倾倒、下胃肠道症状、反流/反流和吞咽/管腔问题；后两个是最密切相关的。手术方法、新辅助治疗、患者年龄和性别是与严重症状相关的因素。
食管癌手术后长期存在症状负担。
