Long-term health-related quality of life for disease-free esophageal cancer patients

World J Surg. 2011 Aug;35(8):1853-60. doi: 10.1007/s00268-011-1123-6.


Background: Health-related quality of life (HRQL) has been studied extensively during the first year following esophagectomy, but little is known about HRQL in long-term survivors. The aim of this study was to investigate HRQL in patients alive at least 1 year after surgical resection for esophageal cancer using validated European Organisation for Research and Treatment of Cancer (EORTC) quality of life (QOL) questionnaires (QLQ).

Methods: Eligible patients, without known disease recurrence and at least 1 year after esophagectomy, were identified from a prospectively maintained database. Patients completed general (QLQ-C30) and esophageal cancer-specific (QLQ-OES18, OG25) questionnaires. A numeric score (0-100) was computed in each conceptual area and compared with validated cancer (n = 1031) and age-matched (n = 7802) healthy populations using two-tailed unpaired t-tests. A cohort of 80 patients had pretreatment scores recorded.

Results: Altogether, 132 of 156 eligible patients (84%) completed the self-rated questionnaire, 105 (67.3%) were men, and the mean age was 62 years (range 29-84 years). The mean time since esophagectomy was 70.3 months (12-299 months). Global health status was significantly reduced at least 1 year after esophagectomy (mean ± SD score 48.4 ± 18.6) when compared with patients with esophageal cancer prior to treatment (55.6 ± 24.1) and the general population (71.2 ± 22.4) (p < 0.0001). In a prospective cohort of eighty patients, symptoms related to swallowing difficulty, reflux, pain, and coughing significantly decreased in the long term (p < 0.0001). The degree of subjective swallowing dysfunction was highly correlated with a poor QOL (Spearman's ρ = 0.508, p < 0.01).

Conclusions: Global health status remains significantly reduced in long-term survivors after esophagectomy compared with population controls, and swallowing dysfunction is highly associated with this compromised QOL.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cohort Studies
  • Esophageal Neoplasms / psychology*
  • Esophageal Neoplasms / surgery*
  • Esophagectomy / psychology*
  • Female
  • Follow-Up Studies
  • Humans
  • Ireland
  • Male
  • Middle Aged
  • Postoperative Complications / psychology
  • Prospective Studies
  • Quality of Life / psychology*
  • Surveys and Questionnaires
  • Survivors / psychology*