Factors predicting survival in patients with advanced oesophageal cancer: a prospective multicentre evaluation.
BACKGROUND
Oesophageal cancer is often diagnosed at an advanced stage, with poor prognosis and severe morbidity. In majority of cases, palliative treatment is the only option available.


OBJECTIVE
To find factors that can predict survival for patients with incurable cancer of the oesophagus or gastro-oesophageal junction and hence aid in the choice of treatment.


METHODS
Ninety-six patients were included. Health-related quality of life questionnaires (EORTC QLQ C-30 and QLQ OES18) were administered and computerized tomography-derived size assessment of the primary tumours was performed. Univariate and multivariate Cox-regression analyses were used to determine potential predictors of survival.


RESULTS
Karnofsky Index, occurrence of metastases (M-stage), Union International Contre le Cancer-stage, computerized tomography-derived tumour size assessment and 10 of 25 scales and single items from the health-related quality of life questionnaires were found to be related to survival. In the multivariate analysis, three of the health-related quality of life questionnaire scales (physical functioning, fatigue and reflux) were found to add prognostic information to M-stage, the single strongest predictor (HR 1.9, P < 0.01).


CONCLUSIONS
In addition to M-stage, the outcome of health-related quality of life questionnaires can sharpen the prediction of survival in patients with advanced cancer of the oesophagus or gastro-oesophageal junction and thus aid in the choice of palliative treatment strategy.
Bergquist
H
H
Department of Otorhinolaryngology, Sahlgrenska University Hospital, Göteborg, Sweden. henrik.bergquist@vgregion.se
Johnsson
A
A
Hammerlid
E
E
Wenger
U
U
Lundell
L
L
Ruth
M
M
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000628:therapy; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy; D003680:Deglutition Disorders / Q000503:physiopathology; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality* / Q000473:pathology* / Q000628:therapy*; D005221:Fatigue / Q000523:psychology; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis / Q000473:pathology; D009367:Neoplasm Staging; D010166:Palliative Care; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D015203:Reproducibility of Results; D012959:Socioeconomic Factors; D015607:Stents; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden