Quality of Life after Open or Minimally Invasive Esophagectomy in Patients With Esophageal Cancer-A Systematic Review

Semin Thorac Cardiovasc Surg. 2017;29(3):377-390. doi: 10.1053/j.semtcvs.2017.08.013. Epub 2017 Aug 24.

Abstract

Although esophageal cancer is rare in the United States, 5-year survival and quality of life (QoL) are poor following esophageal cancer surgery. Although esophageal cancer has been surgically treated with esophagectomy through thoracotomy, an open procedure, minimally invasive surgical procedures have been recently introduced to decrease the risk of complications and improve QoL after surgery. The current study is a systematic review of the published literature to assess differences in QoL after traditional (open) or minimally invasive esophagectomy. We hypothesized that QoL is consistently better in patients treated with minimally invasive surgery than in those treated with a more traditional and invasive approach. Although global health, social function, and emotional function improved more commonly after minimally invasive surgery compared with open surgery, physical function and role function, as well as symptoms including choking, dysphagia, eating problems, and trouble swallowing saliva, declined for both surgery types. Cognitive function was equivocal across both groups. The potential small benefits in global and mental health status among those who experience minimally invasive surgery should be considered with caution given the possibility of publication and selection bias.

Keywords: esophageal cancer; quality of life; surgical type.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Cognition
  • Emotions
  • Esophageal Neoplasms / pathology
  • Esophageal Neoplasms / physiopathology
  • Esophageal Neoplasms / psychology
  • Esophageal Neoplasms / surgery*
  • Esophagectomy / adverse effects
  • Esophagectomy / methods*
  • Health Status
  • Humans
  • Minimally Invasive Surgical Procedures
  • Postoperative Complications / physiopathology
  • Postoperative Complications / psychology
  • Quality of Life*
  • Social Behavior
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome