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Influence of Surgery-related Factors on Quality of Life after Esophageal or Cardia Cancer Resection

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Abstract

Knowledge of how factors related to esophageal cancer resection affect long-term quality of life after surgery is scarce, and no population-based studies are available. Therefore, we conducted a Swedish nationwide, prospective, population-based study of how esophageal surgery–related factors influence quality of life 6 months postoperatively. The Swedish Esophageal and Cardia Cancer register (SECC-register) encompasses 174 hospital departments (97%). Microscopically radically operated patients responded to a validated written questionnaire assessing quality of life. The basic questionnaire (QLQ-C30) and the esophagus-specific module (OES-24) were developed by the European Organization for Research and Treatment of Cancer. The Mann-Whitney test, the Jonckheere-Terpstras test, and logistic regression were used in statistical analyses. Among 100 included patients, the occurrence of surgery-related complications was the main predictor of reduced global quality of life 6 months after surgery (p for trend = 0.03). This effect remained after adjustment for potential confounding variables. Except for anastomotic strictures, each of the predefined complications—i.e., anastomotic leakage, infections, cardiopulmonary complications, and operative technical complications—contributed to decreased quality-of-life scores. Other potentially relevant factors—e.g. degree of lymph node dissection, resection margins, operative blood loss or duration, and hospital type—did not significantly affect quality of life. In conclusion, any measures that can reduce the risk of major surgery–related complications can decrease the negative impact on quality of life after esophageal cancer surgery. More population-based studies are warranted, however.

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Acknowledgments

We are grateful to Eja Fridsta for invaluable help with the fieldwork of the Swedish Esophageal and Cardia Cancer register (SECC-register). We sincerely appreciate the collaboration with all contact doctors that participate in the SECC-register: Erik Aasberg, Gunnar Adell, Stig-Olof Almgren, Christer Andersson, Bengt Anesten, Ebbe Ankeraa, Lena Appelgren, John Blomberg, Bernt Boeryd, Poul Boiesen, Mogens Bove, Mats Broberg, Pawel Burian, Björn Bäckstrand, Tora Campbell-Chiru, Ulf Carlsson, Åke Dahlqvist, Jan Dalenbäck, Stefan Dedorson, Jan Dolata, Thomas Edekling, Kent Edin, Tom Ekstrand, Annika Elmhorn Rosenborg, Lars-Krister Enander, Mats Eriksson, Thomas Eriksson, Bo Erlandsson, Ivan Farago, Elisabeth Flashar Lindahl, Petra Flygare, Ulla Friberg, Signe Friesland, Ashok Gadré, Ulf Gerdes, Per Gullstrand, Olle Gunder, Gustav Gustavsson, Mehmet Gözen, Andrea Halasz, Marianne Hall Angerås, Ann Hammarlund, Jörgen Hansen, Poul Erik Hansen, Mats Hedberg, Lennart Hedenborg, Antti Heikkilä, Per Herlin, Leif Hoffmann-Laursen, Erik Holm, Fredrik Holmner, Hans-Olof Håkansson, Hans Högström, Leif Ingvarsson, Peter Jilcke, Bengt Johansson, Karl-Erik Johansson, Leif Johansson, Sven Johansson, Erik Johnsson, Göran Karlsson, Mats Karlsson, Staffan Kinman, Gerhard Kjellén, Wieslava Kranze, Hans Krook, Richard Kuylenstierna, Anders Kylebäck, Peter Lannes, Sven Larsson, Gustav Levin, Pontus Lidberg, Bengt Liedman, Håkan Liljehohn, Ramon Lillo-Gil, Daniel Lindahl, Gert Lindell, Christer Lindholm, Johan Lindholm, Christina Lindström, Gunilla Ljung, Anders Lundberg, Kjell Lundberg, Lars Lundell, Britta Löden, Ulf Lönn, Ester Lörinc, Shabaz Majid, Janusz Matusik, Kai Melén, Lennart Mellblom, Hans Modig, Eva Munck-Wikland, Torbjörn Myrnäs, Ewa Mårtensson, Torben Navne, Anders Nihlberg, Erik Nilsson, Mats Nilsson, Roland Nilsson, Torgny Nordén, Tomas Norlander, Johan Nyman, Ingmar Näslund, Bengt Ohlander, Bo Ojen, Sante Olling, Bengt Olsson, Håkan Olsson, Mikael Olsson, Rickard Palmkvist, Fredrik Petersson, Johan Ramström, Gunnar Rimbäck, Pehr Rissler, Staffan Rosendahl, Claes Rudberg, Valter Ryd, Thure Rådmark, Björn Sandmark, Charles Silseth, Svante Sjöstedt, Stefan Spinnell, Roger Stenling, Dag Stockeld, Edith Stöckel, Magnus Sundblad, Erik Svartholm, Conny Svensson, Jan-Olov Svensson, Robert Szepesvari, Claes Söderlund, Claes Theander, Stefan Thelin, Maria Thorén Örnberg, Tibor Tot, Torbjörn Tuveson, Maciej Tytor, Sören Vallgren, Svend Vang Petersen, Anders Victorin, Torkel Wahlin, Kjell Wallin, Bruno Walther, Olle Wihlborg, Bo J Wilhelmsson, Åke Östh, and Görel Östberg

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Authors and Affiliations

  1. Department of Surgical Science, Karolinska University Hospital, Solna, Karolinska Institutet, SE-171 76 Stockholm, Sweden

    Pernilla Viklund R.N., Mats Lindblad M.D, Ph.D. & Jesper Lagergren M.D., Ph.D.

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  1. Pernilla Viklund R.N.
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  2. Mats Lindblad M.D, Ph.D.
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  3. Jesper Lagergren M.D., Ph.D.
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Correspondence to Pernilla Viklund R.N..

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Funding was provided by the Swedish Cancer Society and the National Board of Health and Welfare in Sweden.

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Viklund, P., Lindblad, M. & Lagergren, J. Influence of Surgery-related Factors on Quality of Life after Esophageal or Cardia Cancer Resection. World J. Surg. 29, 841–848 (2005). https://doi.org/10.1007/s00268-005-7887-9

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