Pilot Study of Patient-Reported Outcomes in Patients With Esophageal Cancer After Esophagectomy

Patient-reported outcomes (PROs) are critical measures of patient well-being after esophagectomy. In this pilot study, we assessed PROs before and after esophagectomy using the Patient Reported Outcomes Measurement Information System (PROMIS) to assess patient recovery after surgery.

We prospectively collected PROMIS dyspnea severity, physical function, and pain interference measures from patients with esophageal cancer undergoing esophagectomy (2017-2020). We merged these data with our institutional Society of Thoracic Surgery esophagectomy database. We used linear mixed-effect multivariable models to assess changes in PROMIS scores (least square mean [LSM] differences) preoperatively and postoperatively at 1 and 6 months.

The study included 112 patients undergoing esophagectomy. Pain interference, physical function, and dyspnea severity scores were significantly worse 1 month after surgery. While physical function and dyspnea severity scores returned to baseline 6 months after surgery, pain interference scores remained persistently worse (LSM difference, 2.7 ± 2.5; P = .036). PROMIS scores were further assessed among patients undergoing transhiatal esophagectomy compared with transthoracic esophagectomy. Physical function and dyspnea severity scores were similar between the groups at each assessment. However, pain interference scores were persistently better among patients undergoing THE at both 1 month (LSM difference, 6.5 ± 5.1; P = .013) and 6 months after surgery (LSM difference, 5.2 ± 3.9; P = .008).

This pilot study assessing PROMIS scores after esophagectomy for cancer reveals that pain is a persistently reported symptom up to 6 months after surgery, particularly among patients receiving transthoracic esophagectomy.