Health-related quality of life and hospital costs following esophageal resection: a prospective cohort study.
BACKGROUND
The incidence rates for adenocarcinoma of the esophagus are increasing while the prognosis has only improved slightly. There is no apparent benefit in short- and long-term survival after different surgical strategies, but surgery is associated with significant morbidity. The goal of this study is to prospectively assess the quality of life and hospital costs after esophageal resections depending on the development of complications.


METHODS
Prospective data was collected from 47 patients undergoing an esophageal resection for esophageal cancer participating in the prospective LAParotomy or LAParoscopy and Adhesions (LAPAD) study (clinicaltrials.gov registration number: NCT01236625). A comparison was made between patients who developed major complications and minor or no complications regarding quality of life and hospital costs.


RESULTS
Thirteen patients developed major complications while 34 patients developed only minor or no complications. Patients with major complications had a mean hospital cost of $16,369 vs $12,409 for patients without or with minor complications. We found no difference in quality of life between the two groups 6 months after surgery.


CONCLUSIONS
In our cohort, major complications did not seem to have a detrimental effect on postoperative quality of life 6 months after surgery but they increased costs associated with esophageal resection.
Department of surgery, Radboud University Medical Center, postal number 618, P.O. Box 9101, 6500, HB, Nijmegen, Netherlands. chema.strik@radboudumc.nl.
C
C
Strik
Department of surgery, Radboud University Medical Center, postal number 618, P.O. Box 9101, 6500, HB, Nijmegen, Netherlands.
R P
RP
ten Broek
Department of surgery, Radboud University Medical Center, postal number 618, P.O. Box 9101, 6500, HB, Nijmegen, Netherlands.
M
M
van der Kolk
Department of surgery, Radboud University Medical Center, postal number 618, P.O. Box 9101, 6500, HB, Nijmegen, Netherlands.
H
H
van Goor
Department of surgery, Radboud University Medical Center, postal number 618, P.O. Box 9101, 6500, HB, Nijmegen, Netherlands.
J J
JJ
Bonenkamp
D000230:Adenocarcinoma / Q000191:economics* / Q000473:pathology / Q000601:surgery; D000368:Aged; D004938:Esophageal Neoplasms / Q000191:economics* / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D017721:Hospital Costs; D006801:Humans; D010535:Laparoscopy / Q000191:economics*; D007813:Laparotomy / Q000191:economics*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life