A prospective longitudinal study examining the quality of life of patientswith esophageal carcinoma

BACKGROUND. Quality of life (QL) measurement provides detailed information about outcome from the patient's perspective. This study assessed the impac t on short and long term QL of esophagectomy and palliative treatment in pa tients with esophageal carcinoma. METHODS. Consecutive patients undergoing potentially curative esophagectomy or purely palliative treatment completed the European Organization for Res earch and Treatment of Cancer (EORTC) QLQ-C30 and the dysphagia scale from the EORTC QLQ-OES24 before treatment and at regular intervals until death o r for 3 postoperative years. Median scores were calculated for patients sur viving more than 2 years after surgery (n = 17), for patients surviving les s than 2 years after esophagectomy (n = 38), and for patients undergoing pa lliative treatment (n = 37). RESULTS. Baseline functional and symptom QL scores were similar in both gro ups of patients undergoing esophagectomy, and these were better than scores from patients selected for palliative treatment. Six weeks after esophagec tomy, patients reported worse functional, symptom, and global QL scores tha n before treatment. In patients who survived at least 2 years, QL scores re turned to preoperative levels within 9 months, but patients who died within 2 pears of surgery never regained their former QL. In both groups, dysphag ia improved after surgery and the improvement was maintained until death or for the duration of the study. Patients undergoing palliative treatment re ported gradual deterioration in most aspects of QL until death. CONCLUSIONS. Esophagectomy has a negative impact on QL; this effect is tran sient for patients who survive for 2 or more years. This finding should be considered when selecting patients for surgery. Cancer 2000;88:1781-7. (C) 2000 American Cancer Society.