title: Does neoadjuvant treatment before oncologic esophagectomy affect the postoperative quality of life? A prospective, longitudinal outcome study.
abstract: To evaluate the cancer patients' quality of life (QoL) following esophagectomy the focus was placed on the impact of neoadjuvant treatment before surgery. For patients undergoing oncologic surgery, the QoL is generally accepted as an important outcome parameter in addition to clinical parameters. This prospective nonrandomized study evaluated QoL in patients treated by preoperative chemo(radio)therapy followed by either surgery or surgery alone with special focus on the postoperative course. QoL was assessed in 131 consecutive patients who underwent surgery for esophageal cancer. The EORTC-QLQ-C30 and a tumor-specific module were administered before surgery, at discharge, 3, 6, 12, and 24 months after surgery. Clinical data were collected prospectively and a follow up was performed every 6 months. The histological type of cancer was squamous cell carcinoma in 49.6% and adenocarcinoma in 50.4%. There was no significant difference between patients that were treated neoadjuvantly and those that were first operated on with regard to morbidity, mortality, and survival rates (5-year survival rate of 34%). Most QoL scores dropped significantly below the baseline in the early postoperative period and recovered slowly during the follow-up period to almost preoperative levels in many scores. There was no statistically significant difference in any of the QoL scales between neoadjuvantly treated or primary operated patients. Esophageal resections are associated with significant deterioration of QoL, which slowly recovers during the follow-up period to an almost preoperative level. Neoadjuvant treatment seems to not further negatively affect the QoL deterioration.
authors: Department of General Surgery and Thoracic Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Germany.
authors: C
authors: C
authors: Hauser
authors: Department of General Surgery and Thoracic Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Germany.
authors: C
authors: C
authors: Patett
authors: Department of General Surgery and Thoracic Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Germany.
authors: W
authors: W
authors: von Schoenfels
authors: Department of General Surgery and Thoracic Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Germany.
authors: N
authors: N
authors: Heits
authors: Department of General Surgery and Thoracic Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Germany.
authors: C
authors: C
authors: Schafmayer
authors: Reference Center for Quality of Life, University Hospital Schleswig-Holstein, Campus Kiel, Germany.
authors: B
authors: B
authors: Malchow
authors: Department of Internal Medicine, Carl Gustav Carus University Hospital, Dresden, Germany.
authors: J
authors: J
authors: Hampe
authors: Department of General Surgery and Thoracic Surgery, Städtisches Klinikum, Lüneburg, Germany.
authors: B
authors: B
authors: Schniewind
authors: Department of General Surgery and Thoracic Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Germany.
authors: T
authors: T
authors: Becker
authors: Department of General Surgery and Thoracic Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Germany.
authors: J-H
authors: JH
authors: Egberts
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000523:psychology* / Q000628:therapy; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000523:psychology* / Q000628:therapy; D059186:Chemoradiotherapy, Adjuvant; D004938:Esophageal Neoplasms / Q000401:mortality / Q000523:psychology* / Q000628:therapy; D000077277:Esophageal Squamous Cell Carcinoma; D016629:Esophagectomy; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D011184:Postoperative Period; D011446:Prospective Studies; D011788:Quality of Life; D015996:Survival Rate
keywords: esophageal cancer; esophagectomy; esophagogastrostomy; neoadjuvant treatment; quality of life