Abou Chaar Mohamad K, Godin Anny, Saddoughi Sahar A, Harmsen William M, Lee Minji K, Yost Kathleen J, Blackmon Shanda H
Division of Thoracic Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota.
Department of Biostatistics, Mayo Clinic, Rochester, Minnesota.
Ann Thorac Surg Short Rep. 2023 Nov 3;2(1):98-102. doi: 10.1016/j.atssr.2023.09.010. eCollection 2024 Mar.
This prospective study was conducted to determine postesophagectomy symptom severity of esophageal cancer survivors with use of the Upper Digestive Disease (UDD) questionnaire.
A prospective trial included adult esophagectomy patients diagnosed with primary esophageal carcinoma at a single institution from 2000 to 2011. Those who remained alive in 2015 to 2021 were enrolled. Comparison was made between sequential questionnaires.
From a prospective registry of 895 patients with esophagectomy for esophageal cancer, 297 (33%) long-term survivors were identified. Of those, 93 (31%) had recent contact data and 66 (71%) consented and completed the UDD questionnaire. Most participants, 77% (51), were men with a mean age of 57 (±7) years. The mean time from esophagectomy was 12 (8-20) years. The 66 enrolled patients completed 127 UDD questionnaires. A total of 27 (41%) completed at least 2 questionnaires. Poor performance was recorded in the 5 domains as follows: reflux, 19 patients (29%); pain, 3 patients (5%); dysphagia, 0 patients; gastrointestinal dumping, 31 patients (47%); and generalized dumping, 17 patients (26%). Between the first and second questionnaires, dysphagia had the most noticeable improvement in domain score (23/27 [85%]), and reflux had the most regression in domain score (7/27 [26%]).
Patient-reported outcome data are an integral part of esophageal cancer survivorship care. Having a standardized tool that would enhance research and standardize care pathway symptom management is needed.
本前瞻性研究旨在使用上消化道疾病（UDD）问卷确定食管癌幸存者食管切除术后的症状严重程度。
一项前瞻性试验纳入了2000年至2011年在单一机构被诊断为原发性食管癌的成年食管切除术患者。纳入2015年至2021年仍存活的患者。对连续的问卷进行比较。
在895例因食管癌接受食管切除术的患者的前瞻性登记中，确定了297例（33%）长期幸存者。其中，93例（31%）有近期联系数据，66例（71%）同意并完成了UDD问卷。大多数参与者，77%（51例）为男性，平均年龄57（±7）岁。距食管切除术的平均时间为12（8 - 20）年。66例纳入患者共完成了127份UDD问卷。共有27例（41%）完成了至少2份问卷。在5个领域记录到较差的表现如下：反流，19例患者（29%）；疼痛，3例患者（5%）；吞咽困难，0例患者；胃肠道倾倒，31例患者（47%）；全身性倾倒，17例患者（26%）。在第一份和第二份问卷之间，吞咽困难在领域得分方面改善最为明显（23/27 [85%]），反流在领域得分方面退步最为明显（7/27 [26%]）。
患者报告的结局数据是食管癌生存护理的一个组成部分。需要一个标准化工具来加强研究并规范护理路径症状管理。
