Profiling patient-reported symptom recovery from oesophagectomy for patients with oesophageal squamous cell carcinoma: a real-world longitudinal study

Xi Luo; Qin Xie; Qiuling Shi; Yan Miao; Qingsong Yu; Hongfan Yu; Hong Yin; Xuefeng Leng; Yongtao Han; Hong Zhou

doi:10.1007/s00520-021-06711-x

Profiling patient-reported symptom recovery from oesophagectomy for patients with oesophageal squamous cell carcinoma: a real-world longitudinal study

Support Care Cancer. 2022 Mar;30(3):2661-2670. doi: 10.1007/s00520-021-06711-x. Epub 2021 Nov 24.

Authors

Xi Luo^#¹, Qin Xie^#¹, Qiuling Shi^{2

3}, Yan Miao¹, Qingsong Yu², Hongfan Yu², Hong Yin¹, Xuefeng Leng¹, Yongtao Han¹, Hong Zhou⁴

Affiliations

¹ Department of Thoracic Surgery, Sichuan Cancer Hospital and Research Institution, School of Medicine, University of Electronic Science and Technology of China, No.55, Section 4, South Renmin Road, Chengdu, 610041, China.
² School of Public Health and Management, Chongqing Medical University, Chongqing, China.
³ Center for Cancer Prevention Research, Sichuan Cancer Hospital and Research Institution, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
⁴ Department of Thoracic Surgery, Sichuan Cancer Hospital and Research Institution, School of Medicine, University of Electronic Science and Technology of China, No.55, Section 4, South Renmin Road, Chengdu, 610041, China. 291028830@qq.com.

^# Contributed equally.

PMID: 34817693
DOI: 10.1007/s00520-021-06711-x

Abstract

Purpose: Oesophageal squamous cell carcinoma (ESCC) patients have severe symptom burden after oesophagectomy; however, longitudinal studies of symptom recovery after surgery are scarce. This study used longitudinal patient-reported outcome (PRO)-based symptoms to identify severe symptoms and profile symptom recovery from surgery in patients undergoing oesophagectomy.

Methods: Oesophageal cancer patients (N = 327) underwent oesophagectomy were consecutively included between April 2019 and March 2020. Data were extracted from the Sichuan Cancer Hospital's Esophageal Cancer Case Management Registration Database. Symptom assessment time points were pre-surgery and 1, 3, 5, 7, 14, 21, 30, and 90 days post-surgery using the Chinese version of the MD Anderson Symptom Inventory. And each symptom was rated on an 11-point scale, with 0 being 'not present' and 10 being 'as bad as you can imagine'. The symptom recovery trajectories were profiled using mixed effect models and Kaplan-Meier analysis.

Results: The most-severe symptoms on day 1 after oesophagectomy were pain, fatigue, dry mouth, disturbed sleep, and distress. The severity of symptoms peaked on day 1 after surgery. The top two symptoms were fatigue (mean: 5.44 [SD 1.88]) and pain (mean: 5.23 [SD 1.29]). Fatigue was more severe 90 days after surgery than at baseline (mean: 1.77 [SD 1.47] vs 0.65 [SD 1.05]; P < .0001). Disturbed sleep and distress persisted from pre-surgery to 90 days post-surgery; average sleep recovery time was up to 20 days, and 50.58% of patients had sleep disturbances 90 days post-surgery.

Conclusions: Early post-operative pain management after oesophagectomy should be considered. Characteristics and intervention strategies of post-operative fatigue, distress, and disturbed sleep in oesophageal cancer patients warrant further studies.

Keywords: MD Anderson Symptom Inventory; Oesophageal squamous cell carcinoma; Oesophagectomy; Patient-reported outcome.

MeSH terms

Esophageal Neoplasms* / surgery
Esophageal Squamous Cell Carcinoma* / surgery
Esophagectomy / adverse effects
Humans
Longitudinal Studies
Patient Reported Outcome Measures

Abstract

MeSH terms

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