Bonanno Alicia M, Fernandez Felix G
Department of Surgery, Section of General Thoracic Surgery, Emory University School of Medicine, Atlanta, GA, USA.
Department of Surgery, Section of General Thoracic Surgery, The Emory Clinic, Atlanta, GA, USA.
J Thorac Dis. 2024 Oct 31;16(10):7132-7142. doi: 10.21037/jtd-24-487. Epub 2024 Oct 24.
The impact on quality of life (QoL) following esophagectomy is well reported in many studies that have analyzed patient-reported outcomes (PROs). The morbidity surrounding esophagectomy mainly lies within the significant lifestyle changes that can be permanent in some patients. Research efforts in cancer treatments primarily focus on measurements of survival and major morbidity to establish the best therapy that provides the longest survival, but they do not consider the global well-being of the patient. PROs assist in this measurement of QoL and health that is obtained from the patient or caregiver. These instruments are of minimal burden and cost to the patient and are generally utilized before each clinic visit which can help quantify symptoms and improve communication between patients and their surgeons. PROs can also be successfully integrated into the electronic medical records for a standardized approach to collection of data. Review of PRO studies have demonstrated a consensus of an overall decrease in QoL immediately following esophagectomy, but there is a discordance in long-term analyses regarding health-related QoL (HRQoL) scores that return to baseline. This review focuses on methods of gathering and utilizing PRO data, as well as reviewing the current literature regarding QoL research in those undergoing esophagectomy for both short-term and long-term periods.
许多分析患者报告结局(PROs)的研究都详细报道了食管切除术后对生活质量(QoL)的影响。食管切除术后的并发症主要在于一些显著的生活方式改变,这些改变在某些患者中可能是永久性的。癌症治疗方面的研究工作主要集中在生存率和主要并发症的测量上,以确定能提供最长生存期的最佳治疗方法,但并未考虑患者的整体健康状况。PROs有助于对从患者或护理人员那里获得的生活质量和健康状况进行测量。这些工具给患者带来的负担和成本极小,通常在每次门诊就诊前使用,这有助于量化症状并改善患者与其外科医生之间的沟通。PROs还可以成功整合到电子病历中,以实现数据收集的标准化方法。对PRO研究的综述表明,食管切除术后生活质量立即总体下降已达成共识,但在长期分析中,关于恢复到基线水平的健康相关生活质量(HRQoL)评分存在不一致。本综述重点关注收集和利用PRO数据的方法,以及回顾目前关于食管切除术患者短期和长期生活质量研究的文献。