Lasting Symptoms After Esophageal Resection (LASER) European Multicenter Cross-sectional Study
Lasting Symptoms After Esophageal Resection (LASER) European Multicenter Cross-sectional Study
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DOI：
10.1097/sla.0000000000003917
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发表时间：
2022-02-01
影响因子：
9
通讯作者：
Hanna, George B.
中科院分区：
文献类型：
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作者：
Markar, Sheraz R.;Zaninotto, Giovanni;Hanna, George B.
目的：确定食管癌幸存者中最常见的症状和对健康相关生活质量（HRQOL）影响最大的症状。背景：食管切除术后的长期症状负担及其与HRQOL的关系尚不清楚。患者和方法：在2010年至2016年期间，要求来自20个欧洲中心的接受食管癌手术且术后至少1年无疾病的患者完成LASER、EORTC-QLQ-C30和QLQ-OG 25问卷。通过多变量回归分析确定与EORTC QLQ-C30和QLQ-OG 25确定的HRQOL较差相关的特定症状问卷项目，并将其组合形成工具。结果：1081名患者中，共有876人回答了问卷，回答率为81%。其中，66.9%的患者表示在过去6个月内出现了与食管切除术相关的症状。10.4%的患者报告体重持续减轻，只有13.8%的患者返回工作岗位进行相同的活动。在多变量分析中，三种激光症状与HRQOL较差相关：胸部瘢痕疼痛（比值比（OR）1.27; 95% CI 0.97-1.65）、情绪低落（OR 1.42; 95% CI 1.15-1.77）和能量或活动耐受性降低（OR 1.37; 95% CI 1.18-1.59）。开发和验证数据集的曲线下面积分别为0.81 +/- 0.02和0.82 +/- 0.09。结论：三分之二的患者在术后1年以上出现明显症状。本研究中确定的与HRQOL差相关的3个关键症状应进一步验证，并可用于临床实践，以确定需要增加支持的患者。
Objective: To identify the most prevalent symptoms and those with greatest impact upon health-related quality of life (HRQOL) among esophageal cancer survivors. Background: Long-term symptom burden after esophagectomy, and associations with HRQOL, are poorly understood. Patients and Methods: Between 2010 and 2016, patients from 20 European Centers who underwent esophageal cancer surgery, and were disease-free at least 1 year postoperatively were asked to complete LASER, EORTC-QLQ-C30, and QLQ-OG25 questionnaires. Specific symptom questionnaire items that were associated with poor HRQOL as identified by EORTC QLQ-C30 and QLQ-OG25 were identified by multivariable regression analysis and combined to form a tool. Results: A total of 876 of 1081 invited patients responded to the questionnaire, giving a response rate of 81%. Of these, 66.9% stated in the last 6 months they had symptoms associated with their esophagectomy. Ongoing weight loss was reported by 10.4% of patients, and only 13.8% returned to work with the same activities. Three LASER symptoms were correlated with poor HRQOL on multivariable analysis; pain on scars on chest (odds ratio (OR) 1.27; 95% CI 0.97-1.65), low mood (OR 1.42; 95% CI 1.15-1.77) and reduced energy or activity tolerance (OR 1.37; 95% CI 1.18-1.59). The areas under the curves for the development and validation datasets were 0.81 +/- 0.02 and 0.82 +/- 0.09 respectively. Conclusion: Two-thirds of patients experience significant symptoms more than 1 year after surgery. The 3 key symptoms associated with poor HRQOL identified in this study should be further validated, and could be used in clinical practice to identify patients who require increased support.