Comparison of Long-term Quality of Life in Patients with Esophageal Cancer after Ivor-Lewis, Mckeown, or Sweet Esophagectomy

J Gastrointest Surg. 2019 Feb;23(2):225-231. doi: 10.1007/s11605-018-3999-z. Epub 2018 Oct 8.

Abstract

Background: The aim of this study was to compare the long-term quality of life (QoL) in patients after Sweet, Ivor-Lewis, or Mckeown esophagectomy.

Methods: Esophageal cancer patients after Sweet, Ivor-Lewis, or Mckeown esophagectomy from 2010 to 2012 were included. QoL was assessed according to the European Organization for Research and Treatment of Cancer general questionnaire: QLQ-C30 and esophagus-specific questionnaire: QLQ-OES18.

Results: A total of 126 qualified patients who have been alive for more than 3 years without tumor recurrence were divided into three groups: the Sweet group (n = 40), Ivor-Lewis group (n = 38), and Mckeown group (n = 48). Among these three groups, the QLQ-C30 mean scores of global health status, functional and symptom scales, and general QoL were similar. The symptom scales of QLQ-OSE18 showed that patients who had a Mckeown operation experienced more problem of eating (P = 0.029), choking when swallowing (P = 0.010) and coughing (P = 0.016), while patients undergoing Sweet operation complained more symptom of reflux (P = 0.003) and pain (P = 0.000).

Conclusions: All three types of esophagectomy provided a generally good long-term QoL. However, patients in Sweet and Mckeown group tend to suffer from a higher symptomatic burden as compared to Ivor-Lewis approach.

Keywords: Esophageal cancer; Esophagectomy; QLQ-C30; QLQ-OES18; Quality of life (QoL).

Publication types

  • Comparative Study

MeSH terms

  • Esophageal Neoplasms / psychology
  • Esophageal Neoplasms / surgery*
  • Esophagectomy / methods*
  • Female
  • Health Status*
  • Humans
  • Male
  • Middle Aged
  • Postoperative Period
  • Quality of Life*
  • Surveys and Questionnaires