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Scientific article
Open access
English

Long-term quality of life after surgery for adenocarcinoma of the esophagogastric junction: extended gastrectomy or transthoracic esophagectomy?

Published inGastric cancer, vol. 19, no. 1, p. 312-317
Publication date2016-01
First online date2015-01-28
Abstract

Background: Esophagectomy with gastric tube reconstruction and extended transhiatal gastrectomy with Roux-en-Y reconstruction are alternative procedures in current therapeutic concepts for adenocarcinoma of the esophagogastric junction (AEG). The impact of these operations on long-term health-related quality of life (HRQL) is incompletely understood.

Methods: Patients with cancer-free survival of at least 24 months after esophagectomy (ESO) or extended gastrectomy (GAST) for AEG were identified from a prospectively maintained database. EORTC questionnaires were sent out to assess health-related general (QLQ-C30) and cancer-specific (OG-25) quality of life. Numeric scores were calculated for each conceptual area and compared with those of healthy reference populations.

Results: 123 patients (ESO n = 71; GAST n = 52) completed the self-rated questionnaires. HRQL was consistently lower in surgical patients (GAST and ESO) compared with healthy reference populations. Also, there was a general trend for a better HRQL in GAST compared with ESO patients. This trend was statistically significant for physical function (p = 0.04), dyspnea (p = 0.02), and reflux (p = 0.03). Subgroup analysis revealed no significant differences between patients with or without prior neoadjuvant therapy.

Conclusions: After mid- and long-term follow-up, HRQL after extended gastrectomy with Roux-en-Y reconstruction is superior to that after esophagectomy and gastric tube reconstruction. Improved HRQL after gastrectomy is mainly due to less pulmonary and reflux-related symptoms. Our findings may influence the choice of the surgical strategy for patients with AEG.

eng
Keywords
  • Esophagogastric junction cancer
  • Quality of life
  • Surgery
  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery
  • Adult
  • Aged
  • Aged, 80 and over
  • Esophageal Neoplasms / pathology
  • Esophageal Neoplasms / surgery
  • Esophagectomy / methods
  • Esophagogastric Junction / pathology
  • Female
  • Gastrectomy / methods
  • Gastroesophageal Reflux / etiology
  • Humans
  • Male
  • Middle Aged
  • Neoadjuvant Therapy
  • Prospective Studies
  • Quality of Life
  • Reconstructive Surgical Procedures / methods
  • Stomach Neoplasms / surgery
  • Surveys and Questionnaires
  • Young Adult
Affiliation Not a UNIGE publication
Citation (ISO format)
FUCHS, Hans et al. Long-term quality of life after surgery for adenocarcinoma of the esophagogastric junction: extended gastrectomy or transthoracic esophagectomy? In: Gastric cancer, 2016, vol. 19, n° 1, p. 312–317. doi: 10.1007/s10120-015-0466-3
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Article (Published version)
accessLevelPublic
Identifiers
ISSN of the journal1436-3291
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