title: Quality-of-life measures as predictors of post-esophagectomy survival of patients with esophageal cancer.
abstract: OBJECTIVE
  Improving survival after esophagectomy is an important issue in treating patients with esophageal cancer (EC). In addition to standard hospitalization management, periodic assessment of quality-of-life (QOL) measures may be useful to detect disease progression from patients' subjective reports. Therefore, this prospective longitudinal study was undertaken to identify prognostic factors for 3-year survival of EC patients after esophagectomy and to evaluate the impact of QOL measures on these prognostic factors.
  
  
  METHODS
  Patients with EC (n = 67) who had a complete tumor resection and were alive 6 months after esophagectomy were followed in this study for 3 years. Data were collected on patients' sociodemographics, cancer characteristics, adjuvant therapy, general QOL and EC-specific QOL (before esophagectomy and 6 months afterward), cancer recurrence, and death. Patients' independent risk factors for 3-year survival were investigated by multivariate Cox regression analysis.
  
  
  RESULTS
  Of the 67 participants with EC, 26 had late mortality, with a median survival for the whole cohort of 38.2 months (95 % CI 31.97-44.35). Independent predictors of early death were early cancer recurrence (within 6 months after surgery), poor cognitive function (95 % CI 1.020-1.041), and worse dyspnea (95 % CI 1.007-1.034).
  
  
  CONCLUSIONS
  The most predictive factor for early death in EC patients after esophagectomy was cancer recurrence within 6 months after surgery. However, QOL measures could be a tool to provide clinical information from patients' perspective suggesting cancer recurrence.
authors.affiliation: Department of Nursing, Chang Gung Memorial Hospital, Linkou, Tao-Yuan, Taiwan.|Graduate Institute of Clinical Medical Sciences, Chang Gung University, Tao-Yuan, Taiwan.
authors.forename: Yu-Ling
authors.initials: YL
authors.lastname: Chang
authors.affiliation: School of Nursing, College of Medicine, Chang Gung University, 259, Wen-Hwa 1st Road, Tao-Yuan, 333, Taiwan. yftsai@mail.cgu.edu.tw.|Department of Nursing, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan. yftsai@mail.cgu.edu.tw.
authors.forename: Yun-Fang
authors.initials: YF
authors.lastname: Tsai
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan.
authors.forename: Yin-Kai
authors.initials: YK
authors.lastname: Chao
authors.affiliation: Department of Cardiovascular Surgery, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan.
authors.forename: Meng-Yu
authors.initials: MY
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000601:surgery; D016629:Esophagectomy / Q000401:mortality*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Cancer recurrence; Esophageal cancer; Esophagectomy; QOL; Survival