Quality-of-life measures as predictors of post-esophagectomy survival of patients with esophageal cancer

Purpose: Improving survival after esophagectomy is an important issue in treating patients with esophageal cancer (EC). In addition to standard hospitalization management, periodic assessment of quality-of-life (QOL) measures may be useful to detect disease progression from patients’ subjective reports. Therefore, this prospective longitudinal study was undertaken to identify prognostic factors for 3-year survival of EC patients after esophagectomy and to evaluate the impact of QOL measures on these prognostic factors. Methods: Patients with EC (n = 67) who had a complete tumor resection and were alive 6 months after esophagectomy were followed in this study for 3 years. Data were collected on patients’ sociodemographics, cancer characteristics, adjuvant therapy, general QOL and EC-specific QOL (before esophagectomy and 6 months afterward), cancer recurrence, and death. Patients’ independent risk factors for 3-year survival were investigated by multivariate Cox regression analysis. Results: Of the 67 participants with EC, 26 had late mortality, with a median survival for the whole cohort of 38.2 months (95 % CI 31.97–44.35). Independent predictors of early death were early cancer recurrence (within 6 months after surgery), poor cognitive function (95 % CI 1.020–1.041), and worse dyspnea (95 % CI 1.007–1.034). Conclusions: The most predictive factor for early death in EC patients after esophagectomy was cancer recurrence within 6 months after surgery. However, QOL measures could be a tool to provide clinical information from patients’ perspective suggesting cancer recurrence.