title: Long-term health-related quality of life for disease-free esophageal cancer patients.
abstract: BACKGROUND
  Health-related quality of life (HRQL) has been studied extensively during the first year following esophagectomy, but little is known about HRQL in long-term survivors. The aim of this study was to investigate HRQL in patients alive at least 1 year after surgical resection for esophageal cancer using validated European Organisation for Research and Treatment of Cancer (EORTC) quality of life (QOL) questionnaires (QLQ).
  
  
  METHODS
  Eligible patients, without known disease recurrence and at least 1 year after esophagectomy, were identified from a prospectively maintained database. Patients completed general (QLQ-C30) and esophageal cancer-specific (QLQ-OES18, OG25) questionnaires. A numeric score (0-100) was computed in each conceptual area and compared with validated cancer (n = 1031) and age-matched (n = 7802) healthy populations using two-tailed unpaired t-tests. A cohort of 80 patients had pretreatment scores recorded.
  
  
  RESULTS
  Altogether, 132 of 156 eligible patients (84%) completed the self-rated questionnaire, 105 (67.3%) were men, and the mean age was 62 years (range 29-84 years). The mean time since esophagectomy was 70.3 months (12-299 months). Global health status was significantly reduced at least 1 year after esophagectomy (mean ± SD score 48.4 ± 18.6) when compared with patients with esophageal cancer prior to treatment (55.6 ± 24.1) and the general population (71.2 ± 22.4) (p < 0.0001). In a prospective cohort of eighty patients, symptoms related to swallowing difficulty, reflux, pain, and coughing significantly decreased in the long term (p < 0.0001). The degree of subjective swallowing dysfunction was highly correlated with a poor QOL (Spearman's ρ = 0.508, p < 0.01).
  
  
  CONCLUSIONS
  Global health status remains significantly reduced in long-term survivors after esophagectomy compared with population controls, and swallowing dysfunction is highly associated with this compromised QOL.
authors.affiliation: Department of Surgery, Trinity College Dublin/St James' Hospital, Trinity Centre for Health Sciences, St James' Hospital, Dublin 8, Ireland.
authors.forename: Claire L
authors.initials: CL
authors.lastname: Donohoe
authors.forename: Erin
authors.initials: E
authors.lastname: McGillycuddy
authors.forename: John V
authors.initials: JV
authors.lastname: Reynolds
mesh_terms: D000368:Aged; D015331:Cohort Studies; D004938:Esophageal Neoplasms / Q000523:psychology* / Q000601:surgery*; D016629:Esophagectomy / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000523:psychology; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*