Department of Thoracic Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong Province, China.
Guangdong Esophageal Cancer Research Institute, Guangzhou, China.
Ann Surg Oncol. 2023 Nov;30(12):7434-7441. doi: 10.1245/s10434-023-13770-3. Epub 2023 Jun 20.
We aimed to perform serial quality-of-life (QoL) evaluations and comparisons in patients after esophagectomy with intrathoracic anastomosis (IA) or cervical anastomosis (CA).
Between November 2012 and March 2015, patients who underwent esophagectomy with IA or CA for mid-esophageal to distal esophageal or gastroesophageal junction cancer were followed up. QoL was measured using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30) and esophagus-specific questionnaire (EORTC QLQ-OES18) before surgery, at discharge, and at 1, 6, 12, and 24 months after discharge. Linear mixed-effect models were used to assess the mean score differences (MDs) of each QoL scale between the two techniques, and changes in QoL over time. Potential confounders were adjusted.
In total, 219 patients were analyzed (IA, n = 127; CA, n = 92). All patients' QoL decreased immediately after esophagectomy. Global QoL and most functioning and symptom scales exhibited a return to baseline levels within 2 years of discharge, except for physical functioning and several symptoms (dyspnea, diarrhea, dysphagia, and reflux). There was no difference in overall health score between the two groups (MD 2, 95% confidence interval [CI] - 1 to 6). Compared with IA, patients with CA reported more trouble with taste (MD - 12, 95% CI - 19 to - 4) and talking (MD - 11, 95% CI - 19 to 2) at discharge. No differences in long-term QoL were found between groups.
CA was associated with more trouble with taste and talking in the short term than IA. The long-term QoL did not differ between the two approaches.
本研究旨在对经胸内吻合（IA）或颈部吻合（CA）行食管切除术的患者进行系列生存质量（QoL）评估和比较。
2012 年 11 月至 2015 年 3 月，对接受 IA 或 CA 治疗中段食管至下段食管或胃食管交界处癌症的患者进行随访。在术前、出院时以及出院后 1、6、12 和 24 个月，使用欧洲癌症研究与治疗组织生存质量问卷核心 30 项（EORTC QLQ-C30）和食管特异性问卷（EORTC QLQ-OES18）测量 QoL。采用线性混合效应模型评估两种技术之间每个 QoL 量表的平均评分差异（MD），并评估 QoL 的随时间变化情况。调整潜在混杂因素。
共分析了 219 例患者（IA 组，n=127；CA 组，n=92）。所有患者在食管癌手术后 QoL 立即下降。在出院后 2 年内，除生理功能和一些症状（呼吸困难、腹泻、吞咽困难和反流）外，全球 QoL 和大多数功能及症状量表均恢复至基线水平。两组间总体健康评分无差异（MD 2，95%置信区间 [CI] -1 至 6）。与 IA 相比，CA 组患者在出院时味觉（MD -12，95%CI -19 至 -4）和说话（MD -11，95%CI -19 至 2）困难的报告更多。两组间在长期 QoL 方面未发现差异。
CA 与 IA 相比，短期味觉和说话困难更多，但两种方法的长期 QoL 无差异。
