Patients Struggle With Severe Symptoms Even After Surviving Esophagectomy for Esophageal Cancer

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.