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Insights in work rehabilitation after minimally invasive esophagectomy

  • Melissa GeeraertsEmail author
  • Luis Carlos Silva Corten
  • Marc van Det
  • Misha Luyer
  • Grard Nieuwenhuijzen
  • Marloes Vermeer
  • Jelle Ruurda
  • Richard van Hillegersberg
  • Ewout Kouwenhoven
2018 SAGES Oral
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Abstract

Background

Little is known about work rehabilitation after totally minimally invasive esophagectomy. The goal of this study was to further objectify the postoperative work rehabilitation. Not only duration of sick leave, but also the extent of return to work will be assessed.

Methods

This retrospective multicenter study was conveyed between January 2009 and April 2014. Eighty-six preoperatively employed patients were included. Data regarding patients’ preoperative occupation, actual job status, and postoperative duration until return to work were retrieved. Potential prognostic factors for work rehabilitation were analyzed. Complaints that could impede rehabilitation were questioned (based on EORTC QLQ-C30 and QLQ-OES18). Work activity, defined as either partially or fully resumed professional activity as compared to the preoperative status, was measured at 3, 6, 12, and 18 months postoperatively.

Results

At 6-month follow-up, 40.2% of patients reached partial and 14.6% had full professional recovery and after 12 months 28.2% and 40.8%, respectively. After 18 months, a stagnation was seen (19.0% partial; 43.1% full recovery). Median follow-up was 18 months (IQR 12–18). Self-employment was a significant predictor for full professional recovery (p = 0.005, OR 2.45 95% CI 1.32–4.56). The median time to full professional recovery was shorter for this group. The most common complaint among all patients was fatigue. This complaint did not significantly differ between working (fully and partially) and non-working groups (p = 0.727).

Conclusions

Only approximately 40% of patients reached full professional recovery 1 year after totally minimally invasive esophagectomy. Barely any progression toward return to work was seen after 1 year postoperatively. Roughly 30% of patients never returned to work. Self-employed workers had a higher percentage of restoration to full professional activity, as well as shorter duration to return. These findings highlight the importance of adequate counseling of patients in order to prepare them for the impact of this procedure on professional activities.

Keywords

Work rehabilitation Esophageal cancer Minimally invasive esophagectomy 

Notes

Compliance with ethical standards

Disclosures

Melissa Geeraerts, Luis Carlos Silva Corten, Marc van Det, Misha Luyer, Grard Nieuwenhuijzen, Marloes Vermeer, Jelle Ruurda, Richard van Hillegersberg, and Ewout Kouwenhoven have no conflict of interest or financial ties to disclose.

References

  1. 1.
    Chai J, Jamal MM (2012) Esophageal malignancy: a growing concern. World J Gastroenterol 18(45):6521–6526CrossRefGoogle Scholar
  2. 2.
    Malhotra GK, Yanala U, Ravipati A, Follet M, Vijayakumar M, Are C (2017) Global trends in esophageal cancer. J Surg Oncol 115(5):564–579CrossRefGoogle Scholar
  3. 3.
    Greene CL, DeMeester SR, Worrel SG, Oh DS, Hagen JA, DeMeester TR (2014) Alimentary satisfaction, gastrointestinal symptoms, and quality of life 10 or more years after esophagectomy with gastric pull-up. J Thorac Cardiovasc Surg 147(3):909–914CrossRefGoogle Scholar
  4. 4.
    Paul S, Altorki N (2014) Outcomes in the management of esophageal cancer. J Surg Oncol 110(5):599–610CrossRefGoogle Scholar
  5. 5.
    Allum WH, Stenning SP, Bancewicz J, Clark PI, Langley RE (2009) Long-term results of a randomized trial of surgery with or without preoperative chemotherapy in esophageal cancer. J Clin Onco l27(30):5062–5067CrossRefGoogle Scholar
  6. 6.
    Ychou M, Boige V, Pignon JP, Conroy T, Bouché O, Lebreton G, Ducourtieux M, Bedenne L, Fabre JM, Saint-Aubert B, Genève J, Lasser P, Rougier P (2011) Perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma: an FNCLCC and FFCD multicenter phase III trial. J Clin Onco l29(13):1715–1721CrossRefGoogle Scholar
  7. 7.
    Sjoquist KM, Burmeister BH, Smithers BM, Zalcberg JR, Simes RJ, Barbour A, Gebski V, Australasian Gastro-Intestinal Trials Group (2011) Survival after neoadjuvant chemotherapy or chemoradiotherapy for resectable oesophageal carcinoma: an updated meta-analysis. Lancet Oncol 12(7):681–692CrossRefGoogle Scholar
  8. 8.
    van Hagen P, Hulshof MC, van Lanschot JJ, van Berge Henegouwen MI, Wijnhoven BP, Richel DJ, Nieuwenhuijzen GA, Hospers GA, Bonenkamp JJ, Blaisse RJ, Busch OR, tenKate FJ, Creemers GJ, Punt CJ, Plukker JT, Verheul HM, Spillenaar Bilgen EJ, van Dekken H, van derSangen MJ, Rozema T, Biermann K, Beukema JC, Piet AH, van Rij CM, Reinders JG, Tilanus HW, van derGaast A, CROSS Group (2012) Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med 366(22):2074–2084CrossRefGoogle Scholar
  9. 9.
    Mehnert A (2011) Employment and work-related issues in cancer survivors. Crit Rev Oncol Hematol 77(2):109–130CrossRefGoogle Scholar
  10. 10.
    de Boer AG, Verbeek JH, Uitterhoeve AL, Ansink AC, deReijke TM, Kammeijer M, Sprangers MA, vanDijk FJ (2008) Work ability and return-to-work in cancer patients. Br J Cancer 98(8):1342–1347CrossRefGoogle Scholar
  11. 11.
    van Muijen P, Duijts SF, van derBeek AJ, Anema JR (2013) Prognostic factors of work disability in sick-listed cancer survivors. J Cancer Surviv 7(4):582–591CrossRefGoogle Scholar
  12. 12.
    van Muijen P, Duijts SF, Bonefaas-Groenewoud K, van derBeek AJ, Anema JR (2014) Factors associated with work disability in employed cancer survivors at 24-month sick leave. BMC Cancer 14:236CrossRefGoogle Scholar
  13. 13.
    Saotome T, Klein L, Faux S (2015) Cancer rehabilitation: a barometer for survival?Support Care Cancer 23(10):3033–3041CrossRefGoogle Scholar
  14. 14.
    Darling GE (2013) Quality of life in patients with esophageal cancer. Thorac Surg Clin 23(4):569–575CrossRefGoogle Scholar
  15. 15.
    Nafteux P, Durnez J, Moons J, Coosemans W, Decker G, Lerut T, Van Veer H, De Leyn P (2013) Assessing the relationships between health-related quality of life and postoperative length of hospital stay after oesophagectomy for cancer of the oesophagus and the gastro-oesophageal junction. Eur J Cardiothorac Surg 44(3):525–533CrossRefGoogle Scholar
  16. 16.
    Steiner JF, Cavender TA, Main DS, Bradley CJ (2004) Assessing the impact of cancer on work outcomes: what are the research needs? Cancer 101(8):1703–1711CrossRefGoogle Scholar
  17. 17.
    Kennedy F, Haslam C, Munir F, Pryce J (2007) Returning to work following cancer: a qualitative exploratory study into the experience of returning to work following cancer. Eur J Cancer Care 16(1):17–25CrossRefGoogle Scholar
  18. 18.
    Drolet M, Maunsell E, Mondor M, Brisson C, Brisson J, Mâsse B, Deschênes L (2005) Work absence after breast cancer diagnosis: a population-based study. CMAJ 173(7):765–771CrossRefGoogle Scholar
  19. 19.
    Blinder V, Patil S, Eberle C, Griggs J, Maly RC (2013) Early predictors of not returning to work in low-income breast cancer survivors: a 5-year longitudinal study. Breast Cancer Res Treat 140(2):407–416CrossRefGoogle Scholar
  20. 20.
    Gordon L, Lynch BM, Newman B (2008) Transitions in work participation after a diagnosis of colorectal cancer. Aust N Z J Public Health 32(6):569–574CrossRefGoogle Scholar
  21. 21.
    Chen L, Glimelius I, Neovius M, Ekberg S, MartlingA, Eloranta S, Smedby KE (2016) Work loss duration and predictors following rectal cancer treatment among patients with and without prediagnostic. Work Loss Cancer Epidemiol Biomark Prev 25(6):987–994CrossRefGoogle Scholar
  22. 22.
    Pinto E, Cavallin F, Alfieri R, SaadehL M, Mantoan S, Cagol M, Castoro C, Scarpa M (2016) Impact of esophagectomy for cancer on patients’ occupational status. Eur J Surg Oncol 42(1):103–109CrossRefGoogle Scholar
  23. 23.
    Clavien PA, Barkun J, deOliveira ML, Vauthey JN, Dindo D, Schulick RD, de Santibañes E, Pekolj J, Slankamenac K, Bassi C, Graf R, Vonlanthen R, Padbury R, Cameron JL, Makuuchi M (2009) The Clavien–Dindo classification of surgical complications: five-year experience. Ann Surg 250(2):187–196CrossRefGoogle Scholar
  24. 24.
    van Muijen P, Weevers NL, Snels IA, Duijts SF, Bruinvels DJ, Schellart AJ, van derBeek AJ (2013) Predictors of return to work and employment in cancer survivors: a systematic review. Eur J Cancer Care 22(2):144–160CrossRefGoogle Scholar
  25. 25.
    Spelten ER, Verbeek JH, Uitterhoeve AL, Ansink AC, van derLelie J, de Reijke TM, Kammeijer M, deHaes JC, Sprangers MA (2003) Cancer, fatigue and the return of patients to work-a prospective cohort study. Eur J Cancer 39(11):1562–1567CrossRefGoogle Scholar
  26. 26.
    Spelten ER, Sprangers MA, Verbeek JH (2002) Factors reported to influence the return to work of cancer survivors: a literature review. Psychooncology 11(2):124–131CrossRefGoogle Scholar
  27. 27.
    Earle CC, Chretien Y, Morris C, Ayanian JZ, Keating NL, Polgreen LA, Wallace R, Ganz PA, Weeks JC (2010) Employment among survivors of lung cancer and colorectal cancer. J Clin Oncol 28(10):1700–1705CrossRefGoogle Scholar
  28. 28.
    Gordon LG, Beesley VL, Lynch BM, Mihala G, McGrath C, Graves N, Webb PM (2014) The return to work experiences of middle-aged Australian workers diagnosed with colorectal cancer: a matched cohort study. BMC Public Health 14:963CrossRefGoogle Scholar
  29. 29.
    Sanchez KM, Richardson JL, Mason HR (2004) The return to work experiences of colorectal cancer survivors. AAOHN J 52(12):500–510Google Scholar
  30. 30.
    Hornbrook MC, Grant M, Wendel C, Bulkley JE, Mcmullen CK, Altschuler A, Temple LK, Herrinton LJ, Krouse RS (2018) Rectal cancer survivors’ participation in productive activities. Perm J 22:17Google Scholar
  31. 31.
    van denBrink M, van denHout WB, Kievit J, Marijnen CA, Putter H, van deVelde CJ, Stiggelbout AM (2005) The impact of diagnosis and treatment of rectal cancer on paid and unpaid labor. Dis Colon Rectum 48(10):1875–1882CrossRefGoogle Scholar
  32. 32.
    Rodriguez-Bigas MA, Chang GJ, Skibber JM (2007) Barriers to rehabilitation of colorectal cancer patients. J Surg Oncol 1(5):400–408 95(CrossRefGoogle Scholar
  33. 33.
    Siegel RL, Miller KD, Fedewa SA, Ahnen DJ, Meester RGS, Barzi A, Jemal A (2017) Colorectal cancer statistics, 2017. CA Cancer J Clin 67(3):177–193CrossRefGoogle Scholar
  34. 34.
    Donohoe CL, McGillycuddy E, Reynolds JV (2011) Long-term health-related quality of life for disease-free esophageal cancer patients. World J Surg 35(8):1853–1860CrossRefGoogle Scholar
  35. 35.
    Hofman M, Ryan JL, Figueroa-Moseley CD, Jean-Pierre P, Morrow GR (2007) Cancer-related fatigue: the scale of the problem. Oncologist 12(Suppl 1):4–10CrossRefGoogle Scholar
  36. 36.
    Reuter K, Classen CC, Roscoe JA, Morrow GR, Kirshner JJ, Rosenbluth R, Flynn PJ, Shedlock K, Spiegel D (2006) Association of coping style, pain, age and depression with fatigue in women with primary breast cancer. Psychooncology 15(9):772–779CrossRefGoogle Scholar
  37. 37.
    Lubbers M, van Det MJ, Kreuger MJ, Hoekstra R, Hendriksen EM, Vermeer M, Kouwenhoven EA (2018) Totally minimally invasive esophagectomy after neoadjuvant chemoradiotherapy: long-termoncologic outcomes. J Surg Oncol 117(4):651–658CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Melissa Geeraerts
    • 1
    Email author
  • Luis Carlos Silva Corten
    • 1
  • Marc van Det
    • 1
  • Misha Luyer
    • 2
  • Grard Nieuwenhuijzen
    • 2
  • Marloes Vermeer
    • 1
  • Jelle Ruurda
    • 3
  • Richard van Hillegersberg
    • 3
  • Ewout Kouwenhoven
    • 1
  1. 1.Department of SurgeryHospital Group TwenteAlmeloThe Netherlands
  2. 2.Department of SurgeryCatharina HospitalEindhovenThe Netherlands
  3. 3.Department of SurgeryUniversity Medical CentreUtrechtThe Netherlands

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