Long-term quality of life after surgery for adenocarcinoma of the esophagogastric junction: extended gastrectomy or transthoracic esophagectomy?

Autor: S Brinkmann, Stefan P. Mönig, Hakan Alakus, Arnulf H. Hölscher, Jessica M. Leers, Hans F. Fuchs, Marc Bludau, Wolfgang Schröder, Christian A. Gutschow
Přispěvatelé: University of Zurich, Gutschow, Christian A
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Male
Cancer Research
Esophageal Neoplasms
medicine.medical_treatment
Transthoracic esophagectomy
Esophagogastric junction cancer
Adenocarcinoma / pathology
0302 clinical medicine
Quality of life
Surgical oncology
Surveys and Questionnaires
1306 Cancer Research
Prospective Studies
Esophagogastric junction
Esophageal Neoplasms / pathology
Esophageal Neoplasms / surgery
Aged
80 and over
ddc:617
Gastroenterology
Adenocarcinoma / surgery
General Medicine
Middle Aged
humanities
Neoadjuvant Therapy
Oncology
Esophagectomy
030220 oncology & carcinogenesis
Gastroesophageal Reflux
Adenocarcinoma
030211 gastroenterology & hepatology
2730 Oncology
Female
Esophagogastric Junction
Adult
medicine.medical_specialty
Gastrectomy / methods
Reconstructive Surgical Procedures / methods
610 Medicine & health
03 medical and health sciences
Young Adult
Gastrectomy
Stomach Neoplasms
medicine
Humans
2715 Gastroenterology
10217 Clinic for Visceral and Transplantation Surgery
Aged
Esophagogastric Junction / pathology
business.industry
Gastroesophageal Reflux / etiology
Plastic Surgery Procedures
Esophagectomy / methods
medicine.disease
Surgery
Quality of Life
business
Stomach Neoplasms / surgery
Abdominal surgery
Zdroj: Gastric cancer, Vol. 19, No 1 (2016) pp. 312-317
ISSN: 1436-3291
Popis: Background: Esophagectomy with gastric tube reconstruction and extended transhiatal gastrectomy with Roux-en-Y reconstruction are alternative procedures in current therapeutic concepts for adenocarcinoma of the esophagogastric junction (AEG). The impact of these operations on long-term health-related quality of life (HRQL) is incompletely understood.Methods: Patients with cancer-free survival of at least 24 months after esophagectomy (ESO) or extended gastrectomy (GAST) for AEG were identified from a prospectively maintained database. EORTC questionnaires were sent out to assess health-related general (QLQ-C30) and cancer-specific (OG-25) quality of life. Numeric scores were calculated for each conceptual area and compared with those of healthy reference populations.Results: 123 patients (ESO n = 71; GAST n = 52) completed the self-rated questionnaires. HRQL was consistently lower in surgical patients (GAST and ESO) compared with healthy reference populations. Also, there was a general trend for a better HRQL in GAST compared with ESO patients. This trend was statistically significant for physical function (p = 0.04), dyspnea (p = 0.02), and reflux (p = 0.03). Subgroup analysis revealed no significant differences between patients with or without prior neoadjuvant therapy.Conclusions: After mid- and long-term follow-up, HRQL after extended gastrectomy with Roux-en-Y reconstruction is superior to that after esophagectomy and gastric tube reconstruction. Improved HRQL after gastrectomy is mainly due to less pulmonary and reflux-related symptoms. Our findings may influence the choice of the surgical strategy for patients with AEG.
Databáze: OpenAIRE
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