Original Article
Health-related quality of life and survival among 10-year survivors of esophageal cancer surgery: gastric tube reconstruction versus whole stomach reconstruction
Abstract
Background: To compare the health-related quality of life (HRQL) and long-term survival between patients after oncologic esophagectomy with narrow gastric tube (NGT) reconstruction and whole stomach (WS) reconstruction.
Methods: Between 2007 and 2008, a total of 104 patients undergoing esophagectomy were included in this research. Fifty-two patients were enrolled in NGT group and 52 in WS group. HRQL was assessed at 3 weeks, 6 months, 1 year, 2 years, 5 years and 10 years after surgery. The questionnaire was designed with reference to the European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-QES18.
Results: For patients’ baseline characteristics, there was no significant difference between groups. Patients in NGT group had significantly less postoperative reflux than those in WS group. Dysphagia is the only symptom that was significantly worse in WS group than in NGT group at 10 years follow-up. The number of patients presenting good HRQL between groups did not reveal significant differences at 10 years follow-up. The 10-year survival was 33.3% for patients in NGT group and 11.5% for patients in WS group (P<0.05).
Conclusions: Because of a better long-term survival (P=0.027), gastric tube reconstruction may be a better choice for patients undergoing oncologic esophagectomy. HRQL recovers to a level comparable in most patients who survive 10 years after esophagectomy for cancer, although some digestive tract symptoms, like dysphagia, may last during the whole postoperative period and represent a poor prognosis.
Methods: Between 2007 and 2008, a total of 104 patients undergoing esophagectomy were included in this research. Fifty-two patients were enrolled in NGT group and 52 in WS group. HRQL was assessed at 3 weeks, 6 months, 1 year, 2 years, 5 years and 10 years after surgery. The questionnaire was designed with reference to the European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-QES18.
Results: For patients’ baseline characteristics, there was no significant difference between groups. Patients in NGT group had significantly less postoperative reflux than those in WS group. Dysphagia is the only symptom that was significantly worse in WS group than in NGT group at 10 years follow-up. The number of patients presenting good HRQL between groups did not reveal significant differences at 10 years follow-up. The 10-year survival was 33.3% for patients in NGT group and 11.5% for patients in WS group (P<0.05).
Conclusions: Because of a better long-term survival (P=0.027), gastric tube reconstruction may be a better choice for patients undergoing oncologic esophagectomy. HRQL recovers to a level comparable in most patients who survive 10 years after esophagectomy for cancer, although some digestive tract symptoms, like dysphagia, may last during the whole postoperative period and represent a poor prognosis.
