Postoperative Complications and Health-related Quality of Life 10 Years After Esophageal Cancer Surgery

Abstract

Objective: 

To evaluate the impact of postoperative complications on health-related quality of life (HRQOL) up to 10 years after surgery for esophageal cancer.

Background: 

The impact of postoperative complications on HRQOL past 5 years is unknown.

Methods: 

Some 616 patients undergoing open esophageal cancer surgery between April 2, 2001 and December 31, 2005 in Sweden were enrolled in this population-based, nationwide, and prospective cohort study. Exposure was the occurrence of predefined postoperative complications, and the outcome was HRQOL evaluated by validated European Organization for Research and Treatment of Cancer questionnaires at 6 months, 3, 5, and 10 years after surgery. Linear mixed models, adjusted for longitudinal HRQOL in the general population and confounders, provided mean score differences (MDs) with 95% confidence intervals (CIs) for each HRQOL item and scale in patients with or without postoperative complications.

Results: 

At 10 years, 104 (17%) patients were alive and 92 (88%) answered the HRQOL questionnaires. Of these, 37 (40%) had at least 1 predefined postoperative complication. Twelve of the 25 scales and items were significantly worse in patients with postoperative complications 10 years after surgery, for example, physical function (MD −15, 95% CI −24 to −7), fatigue (MD 16, 95% CI 5–26), pain (MD 18, 95% CI 7–30), dyspnea (MD 15, 95% CI 2–27), insomnia (MD 20, 95% CI 8–32), and eating problems (MD 14, 95% CI 3–24) compared to patients without complications.

Conclusions: 

Postoperative complications are associated with considerably impaired HRQOL up to 10 years after esophageal cancer surgery.