205. LONGITUDINAL PATIENT-REPORTED OUTCOMES AFTER MINIMALLY INVASIVE MCKEOWN ESOPHAGECTOMY IN PATIENTS WITH ESOPHAGEAL SQUAMOUS CELL CARCINOMA
Xin Nie, Yan Miao, Wenwu He, Changding Li, Zhiyu Li, Yongtao Han, Chenghao Wang- Gastroenterology
- General Medicine
Abstract
Background
Surgery for esophageal squamous cell carcinoma (ESCC) is characterized by a poor prognosis and high complication rate, resulting in a heavy symptom burden and poor quality of life (QOL). Neoadjuvant therapy followed by surgery improved the postoperative survival of ESCC patients. This study was a longitudinal patient-reported outcomes (PROs) evaluation to compare the effects of neoadjuvant therapy followed by minimally invasive Mckeown esophagectomy and surgery without neoadjuvant therapy from the patient’s perspective.
Methods
We investigated ESCC patients who underwent minimally invasive Mckeown esophagectomy in a single centre. Longitudinal data on clinical characteristics and PROs were collected. The MD Anderson Symptom Inventory and the European Organization for Research and Treatment of Cancer (EORTC)‘s quality of life questionnaires were used to assess symptoms and QOL before and after surgery. Compared the PROs’ trajectories during the investigation.
Results
Overall, 244 eligible ESCC patients were enrolled, of which 78 (group A) underwent neoadjuvant therapy followed by surgery, and 166 (group B) underwent surgery without neoadjuvant therapy. On postoperative day 5, dry mouth (p = 0.035) was more evident in group A. In postoperative month 1, patients in group A reported more disturbed sleep (p = 0.012) and drowsy (p = 0.050). In the sixth month, patients in group A had more symptom burden of disturbed sleep (p = 0.038), distress (p = 0.005) and lack of appetite (p = 0.049), and had worse physical (p = 0.050), role (p = 0.003) and emotional (p = 0.020) functions. Twelve months after surgery, group A had a worse social function (p = 0.019).
Conclusion
The longitudinal changes in postoperative symptoms and QOL were about the same in both groups. But at some point, especially in the sixth month after surgery, patients who underwent neoadjuvant therapy followed by surgery had a heavier symptom burden and a poorer QOL.