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Markar SR, Zaninotto G, Castoro C, et al. Lasting Symptoms After Esophageal Resection (LASER): European Multicenter Cross-sectional Study. Ann Surg. 2020;doi: 10.1097/SLA.0000000000003917.
Markar, S. R., Zaninotto, G., Castoro, C., Johar, A., Lagergren, P., Elliott, J. A., Gisbertz, S. S., Mariette, C., Alfieri, R., Huddy, J., Sounderajah, V., Pinto, E., Scarpa, M., Klevebro, F., Sunde, B., Murphy, C. F., Greene, C., Ravi, N., Piessen, G., Brenkman, H., Ruurda, J. P., Van Hillegersberg, R., Lagarde, S., Wijnhoven, B., Pera, M., Roig, J., Castro, S., Matthijsen, R., Findlay, J., Antonowicz, S., Maynard, N., McCormack, O., Ariyarathenam, A., Sanders, G., Cheong, E., Jaunoo, S., Allum, W., Van Lanschot, J., Nilsson, M., Reynolds, J. V., van Berge Henegouwen, M. I., & Hanna, G. B. (2020). Lasting Symptoms After Esophageal Resection (LASER): European Multicenter Cross-sectional Study. Annals of surgery, . https://doi.org/10.1097/SLA.0000000000003917
Markar, Sheraz R, et al. "Lasting Symptoms After Esophageal Resection (LASER): European Multicenter Cross-sectional Study." Annals of surgery vol. (2020). doi: https://doi.org/10.1097/SLA.0000000000003917
Markar SR, Zaninotto G, Castoro C, Johar A, Lagergren P, Elliott JA, Gisbertz SS, Mariette C, Alfieri R, Huddy J, Sounderajah V, Pinto E, Scarpa M, Klevebro F, Sunde B, Murphy CF, Greene C, Ravi N, Piessen G, Brenkman H, Ruurda JP, Van Hillegersberg R, Lagarde S, Wijnhoven B, Pera M, Roig J, Castro S, Matthijsen R, Findlay J, Antonowicz S, Maynard N, McCormack O, Ariyarathenam A, Sanders G, Cheong E, Jaunoo S, Allum W, Van Lanschot J, Nilsson M, Reynolds JV, van Berge Henegouwen MI, Hanna GB. Lasting Symptoms After Esophageal Resection (LASER): European Multicenter Cross-sectional Study. Ann Surg. 2020 Nov 17; doi: 10.1097/SLA.0000000000003917. Epub 2020 Nov 17. PMID: 32404661.
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Ann Surg. 2020 Nov 17; doi: 10.1097/SLA.0000000000003917. Epub 2020 Nov 17.

Lasting Symptoms After Esophageal Resection (LASER): European Multicenter Cross-sectional Study.

Annals of surgery

Sheraz R Markar, Giovanni Zaninotto, Carlo Castoro, Asif Johar, Pernilla Lagergren, Jessie A Elliott, Suzanne S Gisbertz, Christophe Mariette, Rita Alfieri, Jeremy Huddy, Viknesh Sounderajah, Eleonora Pinto, Marco Scarpa, Fredrik Klevebro, Berit Sunde, Conor F Murphy, Christine Greene, Narayanasamy Ravi, Guillaume Piessen, Hylke Brenkman, Jelle P Ruurda, Richard Van Hillegersberg, Sjoerd Lagarde, Bas Wijnhoven, Manuel Pera, José Roig, Sandra Castro, Robert Matthijsen, John Findlay, Stefan Antonowicz, Nick Maynard, Orla McCormack, Arun Ariyarathenam, Grant Sanders, Edward Cheong, Shameen Jaunoo, William Allum, Jan Van Lanschot, Magnus Nilsson, John V Reynolds, Mark I van Berge Henegouwen, George B Hanna

Affiliations

  1. Department Surgery and Cancer, Imperial College London, UK.
  2. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
  3. Unit of Surgical Oncology of the Esophagus and Digestive Tract, Veneto Institute of Oncology, Padova, Italy.
  4. Division of Upper Gastrointestinal Surgery, Department of Surgery, Humanitas Research Hospital IRCCS, Humanitas University, Rozzano, Milan, Italy.
  5. Department of Surgery, Trinity Centre for Health Sciences, St. James's Hospital and Trinity College Dublin, Dublin, Ireland.
  6. Department of Surgery, Amsterdam UMC, location AMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, the Netherlands.
  7. University Lille, Department of Digestive and Oncological Surgery, Claude Huriez University Hospital, Lille, France.
  8. Department of Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.
  9. Department of Surgery, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
  10. Department of Surgery, University Hospital del Mar, Barcelona, Spain.
  11. Department of Gastrointestinal Surgery, ETZ Tilburg, the Netherlands.
  12. Department of Upper GI Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
  13. Academic Department of Surgery, Royal Marsden Hospital, London, UK.
  14. Department of Oesophago-Gastric Surgery, Plymouth Hospitals NHS Trust, Plymouth, UK.
  15. Department of Upper Gastrointestinal Surgery, Norfolk & Norwich Hospitals NHS Trust, Norwich, UK.
  16. Department of Upper Gastrointestinal Surgery, Gloucestershire Hospitals NHS Foundation Trust, Gloucestershire, UK.
  17. Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm, Sweden.

PMID: 32404661 DOI: 10.1097/SLA.0000000000003917

Abstract

OBJECTIVE: To identify the most prevalent symptoms and those with greatest impact upon health-related quality of life (HRQOL) among esophageal cancer survivors.

BACKGROUND: Long-term symptom burden after esophagectomy, and associations with HRQOL, are poorly understood.

PATIENTS AND METHODS: Between 2010 and 2016, patients from 20 European Centers who underwent esophageal cancer surgery, and were disease-free at least 1 year postoperatively were asked to complete LASER, EORTC-QLQ-C30, and QLQ-OG25 questionnaires. Specific symptom questionnaire items that were associated with poor HRQOL as identified by EORTC QLQ-C30 and QLQ-OG25 were identified by multivariable regression analysis and combined to form a tool.

RESULTS: A total of 876 of 1081 invited patients responded to the questionnaire, giving a response rate of 81%. Of these, 66.9% stated in the last 6 months they had symptoms associated with their esophagectomy. Ongoing weight loss was reported by 10.4% of patients, and only 13.8% returned to work with the same activities.Three LASER symptoms were correlated with poor HRQOL on multivariable analysis; pain on scars on chest (odds ratio (OR) 1.27; 95% CI 0.97-1.65), low mood (OR 1.42; 95% CI 1.15-1.77) and reduced energy or activity tolerance (OR 1.37; 95% CI 1.18-1.59). The areas under the curves for the development and validation datasets were 0.81 ± 0.02 and 0.82 ± 0.09 respectively.

CONCLUSION: Two-thirds of patients experience significant symptoms more than 1 year after surgery. The 3 key symptoms associated with poor HRQOL identified in this study should be further validated, and could be used in clinical practice to identify patients who require increased support.

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