Six-month postoperative quality of life predicts long-term survival after oesophageal cancer surgery
Six-month postoperative quality of life predicts long-term survival after oesophageal cancer surgery
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DOI：
10.1016/j.ejca.2010.10.014
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发表时间：
2011-03-01
影响因子：
8.4
通讯作者：
Lagergren, Pernilla
中科院分区：
文献类型：
--
作者：
Djarv, Therese;Lagergren, Pernilla
背景：食管癌根治性手术治疗患者的5年生存率约为30%。鲜为人知的是，术后健康相关的生活质量（HRQL）和长期survival.Hypothesis之间的关联：不良术后HRQL后治愈预期食管癌手术与减少长期survival.Methods：瑞典全国队列食管癌患者，手术治疗2001年至2005年，随访至死亡或2009年8月底。从术后6个月回答的EORTC QLQ-C30和QLQ-OES18问卷中选择9个HRQL方面进行分析。HRQL测量分为两组：“功能良好”与“功能差”和“无症状或症状轻微”与“有症状”。HRQL和生存之间的关联进行了分析，使用考克斯比例风险比（HR）和95%的置信区间（CI），调整潜在的混杂factors.Findings：所有401食管癌患者术后生存至少6个月，并回答问卷。对于9个选择的结局中的每一个，评分差与死亡率风险比增加相关：（HR = 1.55; 95% CI 1.19 - 2：02），身体功能（HR = 1.56; 95% CI 1.23 - 1.99），社会功能（HR = 1.52; 95% CI 1.19 - 1.94），疲乏（HR = 1.65; 95% CI 1.30 - 2.11），疼痛（HR = 1.45; 95% CI 1.22 - 1.87），呼吸困难（HR = 1.54; 95% CI 1.19 - 2.01），食欲不振（HR = 1.69; 95% CI 1.32 - 2.14），吞咽困难（HR = 1.69; 95% CI 1.13 - 2.51）和食管疼痛（HR = 1.29; 95% CI 1.02 - 1.65）。解释：食管癌手术后6个月评估的HRQL可用作临床有用的预后因子。(c)2010爱思唯尔有限公司版权所有。
Background: Patients treated with curatively intended surgery for oesophageal cancer have an approximately 30% chance of 5-year survival. Little is known about associations between postoperative health-related quality of life (HRQL) and long-term survival.Hypothesis: Poor postoperative HRQL after curatively intended oesophageal cancer surgery is associated with a reduced long-term survival.Methods: A Swedish nationwide cohort of oesophageal cancer patients, treated surgically between 2001 and 2005, was followed up until death or end of August 2009. Nine HRQL aspects were selected for analyses from EORTC QLQ-C30 and QLQ-OES18 questionnaires answered 6 months postoperatively. The HRQL measures were categorised into two groups: 'good function' versus 'poor function' and 'no or minor symptoms' versus 'symptomatic'. Associations between HRQL and survival were analysed using Cox proportional hazard ratios (HR) and 95% confidence intervals (CIs), adjusted for potential confounding factors.Findings: All 401 oesophageal cancer patients who survived at least 6 months postoperatively and responded to the questionnaires were included. For each of the nine selected outcomes, poor scores were associated with an increased hazard ratio of mortality: global HRQL (HR = 1.55; 95% CI 1.19-2:02), physical function (HR = 1.56; 95% CI 1.23-1.99), social function (HR = 1.52; 95% CI 1.19-1.94), fatigue (HR = 1.65; 95% CI 1.30-2.11), pain (HR = 1.45; 95% CI 1.22-1.87), dyspnoea (HR = 1.54; 95% CI 1.19-2.01), appetite loss (HR = 1.69; 95% Cl 1.32-2.14), dysphagia (HR = 1.69; 95% CI 1.13-2.51) and oesophageal pain (HR = 1.29; 95% CI 1.02-1.65).Interpretations: HRQL assessed 6 months after oesophageal cancer surgery can be used as a clinically useful prognostic factor. (c) 2010 Elsevier Ltd. All rights reserved.