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Patient-reported outcomes after oesophagectomy in the multicentre LASER study
S R Markar1,2,3, V Sounderajah1, A Johar2,3
1Department Surgery and Cancer, Imperial College London, London, UK.
The British Journal of Surgery
|May 11, 2021
Summary
Long-term symptom burden is common in patients after oesophageal cancer surgery. Common issues include fatigue, early fullness, and heartburn, impacting quality of life.
Area of Science:
- Oncology
- Gastroenterology
- Surgical Outcomes
Background:
- Limited data exists on the long-term symptom burden experienced by survivors of oesophageal cancer surgery.
- Understanding these persistent symptoms is crucial for improving patient quality of life post-treatment.
Purpose of the Study:
- To identify prevalent symptoms experienced by patients at least one year after oesophageal cancer surgery.
- To investigate the association between these symptoms and health-related quality of life.
- To determine risk factors contributing to severe symptom development.
Main Methods:
- Cross-sectional cohort study involving 876 patients from 20 European centers, surveyed at least one year post-surgery.
- Utilized a 28-symptom questionnaire to assess symptom prevalence.
- Employed principal component analysis for symptom clustering and multivariable logistic regression to identify risk factors.
Main Results:
- Over 66% of patients reported symptoms related to their surgery.
- Most common severe symptoms included reduced energy/activity tolerance (30.7%), early satiety (30.0%), tiredness (28.7%), and heartburn/regurgitation (19.6%).
- Symptoms clustered into six domains, with regurgitation/reflux and swallowing/conduit problems showing the strongest association. Surgical approach, neoadjuvant therapy, age, and sex were linked to severe symptoms.
Conclusions:
- A significant long-term symptom burden is a common outcome for oesophageal cancer surgery survivors.
- Identifying and managing these prevalent symptoms is essential for enhancing patient recovery and well-being.
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