TY - JOUR
T1 - Lasting symptoms and long-term health-related quality of life after totally minimally invasive, hybrid and open Ivor Lewis esophagectomy
AU - Eyck, Ben M.
AU - Klevebro, Fredrik
AU - LASER study group
AU - van der Wilk, Berend J.
AU - Johar, Asif
AU - Wijnhoven, Bas P.L.
AU - van Lanschot, J. Jan B.
AU - Lagergren, Pernilla
AU - Markar, Sheraz R.
AU - Lagarde, Sjoerd M.
N1 - Funding Information: none
Publisher Copyright: © 2021 The Authors
PY - 2022/3
Y1 - 2022/3
N2 - Aim: Compared to open esophagectomy (OE), both totally minimally invasive (TMIE) and laparoscopy-assisted hybrid minimally invasive (HMIE) reduce postoperative morbidity and improve short-term health-related quality of life (HRQoL). We aimed to compare lasting symptoms and long-term HRQoL in an international population-based setting between patients who underwent Ivor Lewis TMIE, HMIE or OE. Methods: Patients who were relapse-free at least one year after TMIE, HMIE or OE for esophageal or junctional carcinoma between January 2010 and June 2016 were included. Patients completed the LASER questionnaire to assess lasting symptoms after esophagectomy and the EORTC QLQ-C30 and QLQ-OG25 questionnaires to assess HRQoL. Primary endpoint was chest pain and secondary endpoints were pain from chest scars or abdominal scars, abdominal pain, fatigue and physical functioning. Differences in lasting symptoms and HRQoL were assessed with multivariable logistic and ANCOVA regression, respectively. Results: A total of 362 patients were included (TMIE n = 91, HMIE n = 85, OE n = 186). Median follow-up was 3.9 years (IQR 2.8–5.4). Chest pain was reported less after TMIE compared with HMIE (adjusted OR 0.21, 95% CI 0.05–0.84), but was comparable between TMIE and OE (adjusted OR 0.41, 95% CI 0.12–1.41) and between HMIE and OE (adjusted OR 1.85, 95% CI 0.71–4.81). All secondary endpoints were comparable between TMIE, HMIE and OE. The impact of symptoms on taking medication, return to work, and performance status were comparable between groups. Conclusion: Surgical technique seems to have little effect on lasting symptoms and long-term HRQoL after a median of four years after Ivor Lewis esophagectomy.
AB - Aim: Compared to open esophagectomy (OE), both totally minimally invasive (TMIE) and laparoscopy-assisted hybrid minimally invasive (HMIE) reduce postoperative morbidity and improve short-term health-related quality of life (HRQoL). We aimed to compare lasting symptoms and long-term HRQoL in an international population-based setting between patients who underwent Ivor Lewis TMIE, HMIE or OE. Methods: Patients who were relapse-free at least one year after TMIE, HMIE or OE for esophageal or junctional carcinoma between January 2010 and June 2016 were included. Patients completed the LASER questionnaire to assess lasting symptoms after esophagectomy and the EORTC QLQ-C30 and QLQ-OG25 questionnaires to assess HRQoL. Primary endpoint was chest pain and secondary endpoints were pain from chest scars or abdominal scars, abdominal pain, fatigue and physical functioning. Differences in lasting symptoms and HRQoL were assessed with multivariable logistic and ANCOVA regression, respectively. Results: A total of 362 patients were included (TMIE n = 91, HMIE n = 85, OE n = 186). Median follow-up was 3.9 years (IQR 2.8–5.4). Chest pain was reported less after TMIE compared with HMIE (adjusted OR 0.21, 95% CI 0.05–0.84), but was comparable between TMIE and OE (adjusted OR 0.41, 95% CI 0.12–1.41) and between HMIE and OE (adjusted OR 1.85, 95% CI 0.71–4.81). All secondary endpoints were comparable between TMIE, HMIE and OE. The impact of symptoms on taking medication, return to work, and performance status were comparable between groups. Conclusion: Surgical technique seems to have little effect on lasting symptoms and long-term HRQoL after a median of four years after Ivor Lewis esophagectomy.
UR - http://www.scopus.com/inward/record.url?scp=85118860044&partnerID=8YFLogxK
U2 - 10.1016/j.ejso.2021.10.023
DO - 10.1016/j.ejso.2021.10.023
M3 - Article
C2 - 34763951
AN - SCOPUS:85118860044
SN - 0748-7983
VL - 48
SP - 582
EP - 588
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
IS - 3
ER -