title: Influence of major postoperative complications on health-related quality of life among long-term survivors of esophageal cancer surgery.
abstract: OBJECTIVE
  To evaluate the effect of major postoperative complications on health-related quality of life (HRQL) in 5-year survivors of esophageal cancer surgery.
  
  
  METHODS
  This study was based on the Swedish Esophageal and Cardia Cancer register with almost complete nationwide coverage and data on esophageal cancer surgery collected prospectively between 2001 and 2005. Patients who were alive 5 years after surgery were eligible. HRQL was assessed longitudinally until 5 years after surgery by using the validated European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire C30 and OES18. Linear mixed models were used to assess the mean score difference (MD) with 95% CIs of each aspect of HRQL in patients with or without major postoperative complications. Adjustment was made for several potential confounders.
  
  
  RESULTS
  Of 153 patients who survived 5 years, 141 patients (92%) answered the 5-year HRQL questionnaires. Of these individuals, 46 patients (33%) sustained a major postoperative complication. Dyspnea (MD, 15; 95% CI, 6 to 23), fatigue (MD, 13; 95% CI, 5 to 20), and eating restrictions (MD, 10; 95% CI, 2 to 17) were clinically and statistically significantly deteriorated throughout the follow-up in patients with major postoperative complications compared with patients without major complications. Although problems with choking declined to levels comparable with patients without major postoperative complications, sleep difficulties and gastroesophageal reflux progressively worsened during follow-up.
  
  
  CONCLUSIONS
  The occurrence of postoperative complications exerts a long-lasting negative effect on HRQL in patients who survive 5 years after esophagectomy for cancer.
authors.affiliation: Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. maryam.derogar@ki.se
authors.forename: Maryam
authors.initials: M
authors.lastname: Derogar
authors.forename: Nicola
authors.initials: N
authors.lastname: Orsini
authors.forename: Omid
authors.initials: O
authors.lastname: Sadr-Azodi
authors.forename: Pernilla
authors.initials: P
authors.lastname: Lagergren
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D016001:Confidence Intervals; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology / Q000523:psychology* / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects* / Q000523:psychology; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000523:psychology*; D011446:Prospective Studies; D011788:Quality of Life; D012042:Registries; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D018434:Sickness Impact Profile; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D013548:Sweden; D013997:Time Factors