食管癌切除术后的长期生活质量

BACKGROUND 背景

Surgery, as part of a multimodal approach, offers the greatest chance of cure for esophageal cancer. However, esophagectomy is often perceived as having a lasting impact on quality of life (QOL), biasing some physicians and patients towards nonoperative management. A comprehensive understanding of the dynamic changes in patient-centered outcomes is thus important for decision-making. Our objective was to determine the long-term QOL post-esophagectomy.

作为多模式方法的一部分，手术为食管癌的治愈提供了最大的机会。然而，食道切除术通常被认为对生活质量(QOL)有持久的影响，使得一些医生和患者倾向于非手术治疗。因此，全面了解以患者为中心的结果的动态变化对决策是重要的。我们的目的是确定食管切除术后的长期生活质量。

METHODS 方法

Data was obtained from a prospectively collected (2006-2015) esophagectomy database at a high-volume center, and patients surviving ≥3 years were identified. Health-related QOL (HRQOL) was evaluated using the Functional Assessment of Cancer Therapy-Esophageal Module (FACT-E) at diagnosis and every 3-6 months and was stratified according to operative approach, stage, complications. Additionally, QOL scores were compared to normative population values.

数据来自前瞻性收集的(2006-2015)大容量中心食管切除术数据库，并确定生存≥3年的患者。健康相关生活质量(HRQOL)在诊断时和每3-6个月使用肿瘤治疗食管模块功能评估(FACT-E)评估一次，并根据手术入路、分期、并发症进行分层。此外，将QOL评分与标准人群值进行比较。

RESULTS 结果

Of 480 patients 47% (n=226) survived ≥3 years and 70% (158/226) completed the HRQOL assessments. Time offollow up was 5.1 ± 2.8 years. After a reduction at 1-3 months, FACT-E increased from a baseline of 126 (95% CI 121-131) to 133 (127-139) at 12 months, and to 147 (142-153) by 5 years. There was no difference in long-term FACT-E with respect to the surgical approach, clinical and pathologic stage, or postoperative complications. At long-term follow-up (>3 years), QOL did not differ significantly from the normative population reference values.

480例患者中47% (n=226)生存≥3年，70%(158/226)完成HRQOL评估。随访时间为5.1±2.8年。1-3个月下降后，12个月时FACT-E从基线126 (95% CI 121-131)增加到133(127-139)，5年后增加到147(142-153)。长期的FACT-E在手术入路、临床和病理阶段或术后并发症方面没有差异。在长期随访(>3年)中，生活质量与标准人群参考值没有显著差异。

CONCLUSIONS 结论

The long-term QOL of esophagectomy patients surviving at least three years is improved when compared to the time of diagnosis and does not differ from the general population.

与确诊时间相比，食管癌切除术后生存至少3年的患者的长期生活质量有所改善，且与普通人群无差异。