Quality of Life Research

, Volume 23, Issue 4, pp 1097–1115

Meta-analysis shows clinically relevant and long-lasting deterioration in health-related quality of life after esophageal cancer surgery

  • M. Jacobs
  • R. C. Macefield
  • R. G. Elbers
  • K. Sitnikova
  • I. J. Korfage
  • E. M. A. Smets
  • I. Henselmans
  • M. I. van Berge Henegouwen
  • J. C. J. M. de Haes
  • J. M. Blazeby
  • M. A. G. Sprangers



The purpose of the study is to (1) estimate the direction, clinical relevance, and duration of health-related quality of life (HRQL) change in the first year following esophageal cancer surgery and (2) to assess the robustness of the estimates by subgroup and sensitivity analyses, and an exploration of publication bias.


A systematic literature search in MEDLINE, EMBASE, CINAHL, PsychINFO, and CENTRAL to identify randomized and non-randomized studies was performed. We compared the baseline HRQL data with 3-, 6-, 9-, or 12-month follow-ups to estimate the magnitude and duration of HRQL change. These estimates were then classified as trivial, small, medium, or large. Primary outcomes were role functioning, eating, and fatigue. Secondary outcomes were physical and social functioning, dysphagia, pain, and coughing problems. We conducted subgroup analysis for open surgery, open surgery preceded by neo-adjuvant therapy, and minimally invasive surgery. Sensitivity analyses assessed the influence of study design, transformation/imputation of the data, and HRQL questionnaire used.


We included data from 15 studies to estimate the change in 28 HRQL outcomes after esophageal cancer surgery. The main analysis showed that patients’ social functioning deteriorated. Symptoms of fatigue, pain, and coughing problems increased. These changes lasted for 9–12 months, although some symptoms persisted beyond the first year after surgery. For many other HRQL outcomes, estimates were only robust after subgroup or sensitivity analyses (e.g., role and physical functioning), or remained too heterogeneous to interpret (e.g., eating and dysphagia).


Patients will experience a clinically relevant and long-lasting deterioration in HRQL after esophageal cancer surgery. However, for many HRQL outcomes, more and better quality evidence is needed.


Esophageal cancer Health-related quality of life Surgery Meta-analysis Patient-reported outcomes 



Health-related quality of life


World Health Organization


Randomized controlled trial


Patient-reported outcome measure


European Organization of Research and Treatment of Cancer Quality of Life Questionnaire Cancer-30


European Organization of Research and Treatment of Cancer Quality of Life Questionnaire Esophagus-18


Standard deviation

95% CI

95% confidence interval


Mean difference


Standardized mean difference


European Organization of Research and Treatment of Cancer Quality of Life Questionnaire Cancer-36


European Organization of Research and Treatment of Cancer Quality of Life Questionnaire Esophagus-24

95% UI

95% uncertainty interval


Minimally important difference


Medical Outcomes Study Short-Form General Health Survey


Medical Outcomes Study Short-Form General Health Survey


Adapted Rotterdam Symptom Checklist


Functional Assessment of Cancer Therapy Scale-Esophageal Cancer


Psychosocial adjustment to illness scale


Profiles of mood states

Supplementary material

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  1. 1.
    Gebski, V., Burmeister, B., Smithers, B. M., Foo, K., Zalcberg, J., & Simes, J. (2007). Survival benefits from neoadjuvant chemoradiotherapy or chemotherapy in oesophageal carcinoma: A meta-analysis. The Lancet Oncology, 8(3), 226–234.PubMedCrossRefGoogle Scholar
  2. 2.
    Rutegard, M., Charonis, K., Lu, Y., Lagergren, P., Lagergren, J., & Rouvelas, I. (2012). Population-based esophageal cancer survival after resection without neoadjuvant therapy: An update. Surgery, 152(2), 903–910.PubMedCrossRefGoogle Scholar
  3. 3.
    Van, H. P., Hulshof, M. C., van Lanschot, J. J., Steyerberg, E. W., van Berge Henegouwen, M. I., Wijnhoven, B. P., et al. (2012). Preoperative chemoradiotherapy for esophageal or junctional cancer. New England Journal of Medicine, 366(22), 2074–2084.CrossRefGoogle Scholar
  4. 4.
    Djarv, T., & Lagergren, P. (2012). Quality of life after esophagectomy for cancer. Expert Review of Gastroenterology & Hepatology, 6(1), 115–122.CrossRefGoogle Scholar
  5. 5.
    Trask, P. C., Hsu, M. A., & McQuellon, R. (2009). Other paradigms: Health-related quality of life as a measure in cancer treatment: its importance and relevance. Cancer Journal, 15(5), 435–440.CrossRefGoogle Scholar
  6. 6.
    Henselmans, I., Jacobs, M., van Berge Henegouwen, M. I., de Haes, H. C., Sprangers, M. A., & Smets, E. M. (2012). Postoperative information needs and communication barriers of esophageal cancer patients. Patient Education and Counseling, 88(1), 138–146.PubMedCrossRefGoogle Scholar
  7. 7.
    Higgins J. P. T., & Green, S. (Eds.). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org. Accessed August 27, 2012.
  8. 8.
    Guyatt, G. H., Oxman, A. D., Vist, G., Kunz, R., Brozek, J., Alonso-Coello, P., et al. (2011). GRADE guidelines: 4. Rating the quality of evidence–study limitations (risk of bias). Journal of Clinical Epidemiology, 64(4), 407–415.PubMedCrossRefGoogle Scholar
  9. 9.
    Whistance, R. N., & Blazeby, J. M. (2011). Systematic review: Quality of life after treatment for upper gastrointestinal cancer. Current Opinion in Supportive and Palliative Care, 5(1), 37–46.PubMedCrossRefGoogle Scholar
  10. 10.
    Conroy, T., Marchal, F., & Blazeby, J. M. (2006). Quality of life in patients with oesophageal and gastric cancer: An overview. Oncology, 70(6), 391–402.PubMedCrossRefGoogle Scholar
  11. 11.
    Parameswaran, R., McNair, A., Avery, K. N., Berrisford, R. G., Wajed, S. A., Sprangers, M. A., et al. (2008). The role of health-related quality of life outcomes in clinical decision making in surgery for esophageal cancer: A systematic review. Annals of Surgical Oncology, 15(9), 2372–2379.PubMedCrossRefGoogle Scholar
  12. 12.
    Sanghera, S. S., Nurkin, S. J., & Demmy, T. L. (2012). Quality of life after an esophagectomy. Surgical Clinics of North America, 92(5), 1315–1335.PubMedCrossRefGoogle Scholar
  13. 13.
    Fernandez, F. G., & Meyers, B. F. (2004). Quality of life after esophagectomy. Seminars in Thoracic and Cardiovascular Surgery, 16(2), 152–159.PubMedCrossRefGoogle Scholar
  14. 14.
    Jacobs, M., Macefield, R. C., Blazeby, J. M., Korfage, I. J., van Berge Henegouwen, M. I., de Haes, H. C., et al. (2012). Systematic review reveals limitations of studies evaluating health-related quality of life after potentially curative treatment for esophageal cancer. Quality of Life Research,. doi:10.1007/s11136-012-0290-8.Google Scholar
  15. 15.
    Borenstein, M., Hedges, L. V., Higgins, J. P., & Rothstein, H. R. (2009). Introduction to meta-analysis. Chichester: Wiley.CrossRefGoogle Scholar
  16. 16.
    Scarpa, M., Valente, S., Alfieri, R., Cagol, M., Diamantis, G., Ancona, E., et al. (2011). Systematic review of health-related quality of life after esophagectomy for esophageal cancer. World Journal of Gastroenterology, 17(42), 4660–4674.PubMedCentralPubMedCrossRefGoogle Scholar
  17. 17.
    Maringwa, J. T., Quinten, C., King, M., Ringash, J., Osoba, D., Coens, C., et al. (2011). Minimal important differences for interpreting health-related quality of life scores from the EORTC QLQ-C30 in lung cancer patients participating in randomized controlled trials. Supportive Care in Cancer, 19(11), 1753–1760.PubMedCrossRefGoogle Scholar
  18. 18.
    Shrier, I., Boivin, J. F., Steele, R. J., Platt, R. W., Furlan, A., Kakuma, R., et al. (2007). Should meta-analyses of interventions include observational studies in addition to randomized controlled trials? A critical examination of underlying principles. American Journal of Epidemiology, 166(10), 1203–1209.PubMedCrossRefGoogle Scholar
  19. 19.
    Ioannidis, J. P., Patsopoulos, N. A., & Rothstein, H. R. (2008). Reasons or excuses for avoiding meta-analysis in forest plots. British Medical Journal, 336(7658), 1413–1415.PubMedCentralPubMedCrossRefGoogle Scholar
  20. 20.
    Vandenbroucke, J. P. (2011). Why do the results of randomised and observational studies differ? British Medical Journal, 343, d7020.PubMedCrossRefGoogle Scholar
  21. 21.
    Avery, K. N., Metcalfe, C., Barham, C. P., Alderson, D., Falk, S. J., & Blazeby, J. M. (2007). Quality of life during potentially curative treatment for locally advanced oesophageal cancer. British Journal of Surgery, 94(11), 1369–1376.PubMedCrossRefGoogle Scholar
  22. 22.
    Howick, J., Chalmers, I., Glasziou, P., Greenhalgh, T., Heneghan, C., Liberati, A. et al. (2011). Explanation of the 2011 Oxford centre for evidence-based medicine (OCEBM) levels of evidence (Background Document). Oxford centre for evidence-based medicine. http://www.cebm.net/index.aspx?o=5653. Accessed 27 August 2012.
  23. 23.
    Efficace, F., Bottomley, A., Osoba, D., Gotay, C., Flechtner, H., D’haese, S., et al. (2003). Beyond the development of health-related quality-of-life (HRQOL) measures: A checklist for evaluating HRQOL outcomes in cancer clinical trials–does HRQOL evaluation in prostate cancer research inform clinical decision making? Journal of Clinical Oncology, 21, 3502–3511.PubMedCrossRefGoogle Scholar
  24. 24.
    Blazeby, J. M., Conroy, T., Hammerlid, E., Fayers, P., Sezer, O., Koller, M., et al. (2003). Clinical and psychometric validation of an EORTC questionnaire module, the EORTC QLQ-OES18, to assess quality of life in patients with oesophageal cancer. European Journal of Cancer, 39(10), 1384–1394.PubMedCrossRefGoogle Scholar
  25. 25.
    Blazeby, J. M., Alderson, D., Winstone, K., Steyn, R., Hammerlid, E., Arraras, J., et al. (1996). Development of an EORTC questionnaire module to be used in quality of life assessment for patients with oesophageal cancer. The EORTC Quality of Life Study Group. European Journal of Cancer, 32(11), 1912–1917.CrossRefGoogle Scholar
  26. 26.
    DerSimonian, R., & Laird, N. (1986). Meta-analysis in clinical trials. Controlled Clinical Trials, 7(3), 177–188.PubMedCrossRefGoogle Scholar
  27. 27.
    Riley, R. D., Higgins, J. P., & Deeks, J. J. (2011). Interpretation of random effects meta-analyses. British Medical Journal, 342, d549.PubMedCrossRefGoogle Scholar
  28. 28.
    Higgins, J. P., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003). Measuring inconsistency in meta-analyses. British Medical Journal, 327(7414), 557–560.PubMedCentralPubMedCrossRefGoogle Scholar
  29. 29.
    Higgins, J. P., & Thompson, S. G. (2002). Quantifying heterogeneity in a meta-analysis. Statistics in Medicine, 21(11), 1539–1558.PubMedCrossRefGoogle Scholar
  30. 30.
    Ioannidis, J. P., Patsopoulos, N. A., & Evangelou, E. (2007). Uncertainty in heterogeneity estimates in meta-analyses. British Medical Journal, 335(7626), 914–916.PubMedCentralPubMedCrossRefGoogle Scholar
  31. 31.
    Cocks, K., King, M. T., Velikova, G., de, C. G., Jr., Martyn St-James, M., & Fayers, P. M. et al. (2012). Evidence-based guidelines for interpreting change scores for the European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30. European Journal of Cancer, 48(11), 1713–1721.Google Scholar
  32. 32.
    Osoba, D., Rodrigues, G., Myles, J., Zee, B., & Pater, J. (1998). Interpreting the significance of changes in health-related quality-of-life scores. Journal of Clinical Oncology, 16(1), 139–144.PubMedGoogle Scholar
  33. 33.
    Cohen, J. (1988). Statistical power analysis in the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum Associates Inc.Google Scholar
  34. 34.
    Boshier, P. R., Anderson, O., & Hanna, G. B. (2011). Transthoracic versus transhiatal esophagectomy for the treatment of esophagogastric cancer: A meta-analysis. Annals of Surgery, 254(6), 894–906.PubMedCrossRefGoogle Scholar
  35. 35.
    Hulscher, J. B., van Sandick, J. W., de Boer, A. G., Wijnhoven, B. P., Tijssen, J. G., Fockens, P., et al. (2002). Extended transthoracic resection compared with limited transhiatal resection for adenocarcinoma of the esophagus. New England Journal of Medicine, 347(21), 1662–1669.PubMedCrossRefGoogle Scholar
  36. 36.
    Chang, A. C., Ji, H., Birkmeyer, N. J., Orringer, M. B., & Birkmeyer, J. D. (2008). Outcomes after transhiatal and transthoracic esophagectomy for cancer. Annals of Thoracic Surgery, 85(2), 424–429.PubMedCrossRefGoogle Scholar
  37. 37.
    Rutegard, M., Lagergren, J., Rouvelas, I., Lindblad, M., Blazeby, J. M., & Lagergren, P. (2008). Population-based study of surgical factors in relation to health-related quality of life after oesophageal cancer resection. British Journal of Surgery, 95(5), 592–601.PubMedCrossRefGoogle Scholar
  38. 38.
    Yang, K., Chen, H. N., Chen, X. Z., Lu, Q. C., Pan, L., Liu, J., et al. (2012). Transthoracic resection versus non-transthoracic resection for gastroesophageal junction cancer: A meta-analysis. PLoS ONE, 7(6), e37698.PubMedCentralPubMedCrossRefGoogle Scholar
  39. 39.
    Sjoquist, K. M., Burmeister, B. H., Smithers, B. M., Zalcberg, J. R., Simes, R. J., Barbour, A., et al. (2011). Survival after neoadjuvant chemotherapy or chemoradiotherapy for resectable oesophageal carcinoma: An updated meta-analysis. The Lancet Oncology, 12(7), 681–692.PubMedCrossRefGoogle Scholar
  40. 40.
    Fedeli, U., Schievano, E., & Lisiero, M. (2012). Mortality after esophageal and gastric cancer resection. World Journal of Surgery, 36(11), 2630–2636.PubMedCrossRefGoogle Scholar
  41. 41.
    Biere, S. S., Maas, K. W., Bonavina, L., Garcia, J. R., van Berge Henegouwen, M. I., Rosman, C., et al. (2011). Traditional invasive versus minimally invasive esophagectomy: A multi-center, randomized trial (TIME-trial). British Medical Journal Surgery, 11, 2.Google Scholar
  42. 42.
    Shah, R., & Jobe, B. A. (2011). Open versus minimally invasive esophagectomy: What is the best approach? Minimally invasive esophagectomy. Journal of Gastrointestinal Surgery, 15(9), 1503–1505.PubMedCrossRefGoogle Scholar
  43. 43.
    Duval, S., & Tweedie, R. (2000). Trim and fill: A simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics, 56(2), 455–463.PubMedCrossRefGoogle Scholar
  44. 44.
    Rosenthal, R. (1979). The ‘file drawer problem’ and tolerance for null results. Psychological Bulletin, 86, 638–641.CrossRefGoogle Scholar
  45. 45.
    Egger, M., Davey, S. G., Schneider, M., & Minder, C. (1997). Bias in meta-analysis detected by a simple, graphical test. British Medical Journal, 315(7109), 629–634.PubMedCentralPubMedCrossRefGoogle Scholar
  46. 46.
    Teoh, A. Y., Yan Chiu, P. W., Wong, T. C., Liu, S. Y., Hung Wong, S. K., & Ng, E. K. (2011). Functional performance and quality of life in patients with squamous esophageal carcinoma receiving surgery or chemoradiation: Results from a randomized trial. Annals of Surgery, 253(1), 1–5.PubMedCrossRefGoogle Scholar
  47. 47.
    Nafteux, P., Moons, J., Coosemans, W., Decaluwe, H., Decker, G., De, L. P., et al. (2011). Minimally invasive oesophagectomy: A valuable alternative to open oesophagectomy for the treatment of early oesophageal and gastro-oesophageal junction carcinoma. European Journal of Cardio-Thoracic Surgery, 40(6), 1455–1463.PubMedGoogle Scholar
  48. 48.
    Parameswaran, R., Blazeby, J. M., Hughes, R., Mitchell, K., Berrisford, R. G., & Wajed, S. A. (2010). Health-related quality of life after minimally invasive oesophagectomy. British Journal of Surgery, 97(4), 525–531.PubMedCrossRefGoogle Scholar
  49. 49.
    Wang, H., Tan, L., Feng, M., Zhang, Y., & Wang, Q. (2011). Comparison of the short-term health-related quality of life in patients with esophageal cancer with different routes of gastric tube reconstruction after minimally invasive esophagectomy. Quality of Life Research, 20(2), 179–189.PubMedCrossRefGoogle Scholar
  50. 50.
    Wang, H., Feng, M., Tan, L., & Wang, Q. (2010). Comparison of the short-term quality of life in patients with esophageal cancer after subtotal esophagectomy via video-assisted thoracoscopic or open surgery. Diseases of the Esophagus, 23(5), 408–414.PubMedGoogle Scholar
  51. 51.
    Safieddine, N., Xu, W., Quadri, S. M., Knox, J. J., Hornby, J., Sulman, J., et al. (2009). Health-related quality of life in esophageal cancer: Effect of neoadjuvant chemoradiotherapy followed by surgical intervention. Journal of Thoracic and Cardiovascular Surgery, 137(1), 36–42.PubMedCrossRefGoogle Scholar
  52. 52.
    van Meerten, E., van der Gaast, A., Looman, C. W., Tilanus, H. W., Muller, K., & Essink-Bot, M. L. (2008). Quality of life during neoadjuvant treatment and after surgery for resectable esophageal carcinoma. International Journal of Radiation Oncology Biology Physics, 71(1), 160–166.CrossRefGoogle Scholar
  53. 53.
    Barbour, A. P., Lagergren, P., Hughes, R., Alderson, D., Barham, C. P., & Blazeby, J. M. (2008). Health-related quality of life among patients with adenocarcinoma of the gastro-oesophageal junction treated by gastrectomy or oesophagectomy. British Journal of Surgery, 95(1), 80–84.PubMedCrossRefGoogle Scholar
  54. 54.
    Lagergren, P., Avery, K. N. L., Hughes, R., Barham, C. P., Alderson, D., Falk, S. J. et al. Health-related quality of life among patients cured by surgery for esophageal cancer. Cancer, 110(3), 686–693. Google Scholar
  55. 55.
    Tan, Q. Y., Wang, R. W., Jiang, Y. G., Fan, S. Z., Hsin, M. K., Gong, T. Q., et al. (2006). Lung volume reduction surgery allows esophageal tumor resection in selected esophageal carcinoma with severe emphysema. Annals of Thoracic Surgery, 82(5), 1849–1856.PubMedCrossRefGoogle Scholar
  56. 56.
    Reynolds, J. V., McLaughlin, R., Moore, J., Rowley, S., Ravi, N., & Byrne, P. J. (2006). Prospective evaluation of quality of life in patients with localized oesophageal cancer treated by multimodality therapy or surgery alone. British Journal of Surgery, 93(9), 1084–1090.PubMedCrossRefGoogle Scholar
  57. 57.
    de Boer, A. G., van Lanschot, J. J., van Sandick, J. W., Hulscher, J. B., Stalmeier, P. F., de Haes, J. C., et al. (2004). Quality of life after transhiatal compared with extended transthoracic resection for adenocarcinoma of the esophagus. Journal of Clinical Oncology, 22(20), 4202–4208.PubMedCrossRefGoogle Scholar
  58. 58.
    Brooks, J. A., Kesler, K. A., Johnson, C. S., Ciaccia, D., & Brown, J. W. (2002). Prospective analysis of quality of life after surgical resection for esophageal cancer: Preliminary results. Journal of Surgical Oncology, 81(4), 185–194.PubMedCrossRefGoogle Scholar
  59. 59.
    Scarpa, M., Saadeh, L. M., Fasolo, A., Alfieri, R., Cagol, M., Cavallin, F., et al. (2013). Health-related quality of life in patients with oesophageal cancer: Analysis at different steps of the treatment pathway. Journal of Gastrointestinal Surgery,. doi:10.1007/s11605-012-2069-1.Google Scholar
  60. 60.
    Biere, S. S., van Berge Henegouwen, M. I., Maas, K. W., Bonavina, L., Rosman, C., Garcia, J. R., et al. (2012). Minimally invasive versus open oesophagectomy for patients with oesophageal cancer: A multicentre, open-label, randomised controlled trial. Lancet, 379(9829), 1887–1892.PubMedCrossRefGoogle Scholar
  61. 61.
    Briez, N., Piessen, G., Bonnetain, F., Brigand, C., Carrere, N., Collet, D., et al. (2011). Open versus laparoscopically-assisted oesophagectomy for cancer: A multicentre randomised controlled phase III trial—the MIRO trial. BMC Cancer, 11(310), 310.PubMedCentralPubMedCrossRefGoogle Scholar
  62. 62.
    Zhang, C., Wu, Q. C., Hou, P. Y., Zhang, M., Li, Q., Jiang, Y. J., et al. (2011). Impact of the method of reconstruction after oncologic oesophagectomy on quality of life—a prospective, randomised study. European Journal of Cardio-Thoracic Surgery, 39(1), 109–114.PubMedCrossRefGoogle Scholar
  63. 63.
    Steyerberg, E. W. (2009). Clinical prediction models. New York: Springer.CrossRefGoogle Scholar
  64. 64.
    Derogar, M., Orsini, N., Sadr-Azodi, O., & Lagergren, P. (2012). Influence of major postoperative complications on health-related quality of life among long-term survivors of esophageal cancer surgery. Journal of Clinical Oncology, 30(14), 1615–1619.PubMedCrossRefGoogle Scholar
  65. 65.
    Sprangers, M. A., Sloan, J. A., Barsevick, A., Chauhan, C., Dueck, A. C., Raat, H., et al. (2010). Scientific imperatives, clinical implications, and theoretical underpinnings for the investigation of the relationship between genetic variables and patient-reported quality-of-life outcomes. Quality of Life Research, 19(10), 1395–1403.PubMedCentralPubMedCrossRefGoogle Scholar
  66. 66.
    Lagergren, J., & Lagergren, P. (2013). Recent developments in esophageal adenocarcinoma. CA: A Cancer Journal for Clinicians,. doi:10.1002/caac.21185.Google Scholar
  67. 67.
    Wood, L., Egger, M., Gluud, L. L., Schulz, K. F., Juni, P., Altman, D. G., et al. (2008). Empirical evidence of bias in treatment effect estimates in controlled trials with different interventions and outcomes: Meta-epidemiological study. British Medical Journal, 336(7644), 601–605.PubMedCentralPubMedCrossRefGoogle Scholar
  68. 68.
    Moher, D., Pham, B., Lawson, M. L., & Klassen, T. P. (2003). The inclusion of reports of randomised trials published in languages other than English in systematic reviews. Health Technology Assessment, 7(41), 1–90.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • M. Jacobs
    • 1
  • R. C. Macefield
    • 2
  • R. G. Elbers
    • 3
  • K. Sitnikova
    • 1
  • I. J. Korfage
    • 4
  • E. M. A. Smets
    • 1
  • I. Henselmans
    • 1
  • M. I. van Berge Henegouwen
    • 5
  • J. C. J. M. de Haes
    • 1
  • J. M. Blazeby
    • 2
    • 6
  • M. A. G. Sprangers
    • 1
  1. 1.Department of Medical Psychology, Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
  2. 2.School of Social and Community MedicineUniversity of BristolBristolUK
  3. 3.Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
  4. 4.Department of Public HealthUniversity Medical Center RotterdamRotterdamThe Netherlands
  5. 5.Department of Surgery, Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
  6. 6.Division of Surgery Head and NeckUniversity Hospitals Bristol NHS Foundation TrustBristolUK

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