Department of Thoracic Surgery, Sichuan Cancer Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan, 610041, People's Republic of China.
Support Care Cancer. 2024 Mar 20;32(4):237. doi: 10.1007/s00520-024-08428-z.
Surgery for esophageal squamous cell carcinoma (ESCC) is characterized by a poor prognosis and high complication rate, resulting in a heavy symptom burden and poor health-related quality of life (QOL). We evaluated longitudinal patient-reported outcomes (PROs) to analyze the correlations between symptoms and QOL and their changing characteristics during postoperative rehabilitation.
We investigated patients with ESCC who underwent minimally invasive McKeown esophagectomy at Sichuan Cancer Hospital between April 2019 and December 2019. Longitudinal data of the clinical characteristics and PROs were collected. The MD Anderson Symptom Inventory and European Organization for Research and Treatment of Cancer (EORTC) QOL questionnaires were used to assess symptoms and QOL and compare the trajectories of PROs during the investigation.
A total of 244 patients with ESCC were enrolled in this study. Regarding QOL, role and emotional functions returned to baseline at 1 month after surgery, and cognitive and social functions returned to baseline at 3 months after surgery. However, physical function and global QOL did not return to baseline at 1 year after surgery. At 7 days and 1, 3, 6, and 12 months after surgery, the main symptoms of the patients were negatively correlated with physical, role, emotional, cognitive, and social functions and the overall health status (P < 0.05).
Patients with ESCC experience reduced health-related QOL and persisting symptoms after minimally invasive McKeown esophagectomy, but a recovery trend was observed within 1 month. The long-term QOL after esophagectomy is acceptable.
食管鳞状细胞癌（ESCC）的手术特点是预后不良和高并发症发生率，导致症状负担沉重，健康相关生活质量（QOL）较差。我们评估了纵向患者报告的结果（PROs），以分析症状与 QOL 之间的相关性及其在术后康复过程中的变化特征。
我们调查了 2019 年 4 月至 2019 年 12 月在四川肿瘤医院接受微创 McKeown 食管切除术的 ESCC 患者。收集了患者的临床特征和 PROs 的纵向数据。使用 MD Anderson 症状量表和欧洲癌症研究与治疗组织（EORTC）生活质量问卷评估症状和 QOL，并比较了调查期间 PROs 的轨迹。
本研究共纳入 244 例 ESCC 患者。关于 QOL，角色和情绪功能在手术后 1 个月恢复到基线，认知和社会功能在手术后 3 个月恢复到基线。然而，身体功能和总体 QOL在手术后 1 年未恢复到基线。手术后 7 天和 1、3、6 和 12 个月，患者的主要症状与身体、角色、情绪、认知和社会功能以及整体健康状况呈负相关（P<0.05）。
微创 McKeown 食管切除术后，ESCC 患者的健康相关 QOL 降低且症状持续存在，但在 1 个月内观察到恢复趋势。手术后的长期 QOL 是可以接受的。
