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

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

doi:10.1097/SLA.0000000000003917

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

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

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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.

Original language	English
Pages (from-to)	e392-e400
Journal	Annals of Surgery
Volume	275
Issue number	2
Early online date	17 Nov 2020
DOIs	https://doi.org/10.1097/SLA.0000000000003917
Publication status	Published - Feb 2022

Keywords

esophageal cancer
quality of life
survivorship
symptoms

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Lasting_Symptoms_After_Esophageal_Resection.44Final published version, 1.1 MBLicence: Taverne

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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., ... Hanna, G. B. (2022). Lasting Symptoms After Esophageal Resection (LASER): European Multicenter Cross-sectional Study. Annals of Surgery, 275(2), e392-e400. https://doi.org/10.1097/SLA.0000000000003917

@article{6dedb5e249584b7d9b9f2b8d1211478b,

title = "Lasting Symptoms After Esophageal Resection (LASER): European Multicenter Cross-sectional Study",

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.",

keywords = "esophageal cancer, quality of life, survivorship, symptoms",

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

note = "Funding Information: Mr S.R.M. received the European Society for Medical Oncology Clinical Research Fellowship for the support of this study. Mr S.R.M. is supported by an NIHR Academic Clinical Lectureship and acknowledges support from the National Institute for Health Research (NIHR) Imperial Biomedical Research Centre (BRC). This study was also supported by the NIHR London IVD Co-operative and the Morgagni Charity. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health. Publisher Copyright: {\textcopyright} 2022 Wolters Kluwer Health, Inc. All rights reserved.",

year = "2022",

month = feb,

doi = "10.1097/SLA.0000000000003917",

language = "English",

volume = "275",

pages = "e392--e400",

journal = "Annals of Surgery",

issn = "0003-4932",

publisher = "Wolters Kluwer Health",

number = "2",

}

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, Henegouwen, MIVB & Hanna, GB 2022, 'Lasting Symptoms After Esophageal Resection (LASER): European Multicenter Cross-sectional Study', Annals of Surgery, vol. 275, no. 2, pp. e392-e400. https://doi.org/10.1097/SLA.0000000000003917

TY - JOUR

T1 - Lasting Symptoms After Esophageal Resection (LASER)

T2 - European Multicenter Cross-sectional Study

AU - Markar, Sheraz R

AU - Zaninotto, Giovanni

AU - Castoro, Carlo

AU - Johar, Asif

AU - Lagergren, Pernilla

AU - Elliott, Jessie A

AU - Gisbertz, Suzanne S

AU - Mariette, Christophe

AU - Alfieri, Rita

AU - Huddy, Jeremy

AU - Sounderajah, Viknesh

AU - Pinto, Eleonora

AU - Scarpa, Marco

AU - Klevebro, Fredrik

AU - Sunde, Berit

AU - Murphy, Conor F

AU - Greene, Christine

AU - Ravi, Narayanasamy

AU - Piessen, Guillaume

AU - Brenkman, Hylke

AU - Ruurda, Jelle P

AU - Van Hillegersberg, Richard

AU - Lagarde, Sjoerd

AU - Wijnhoven, Bas

AU - Pera, Manuel

AU - Roig, José

AU - Castro, Sandra

AU - Matthijsen, Robert

AU - Findlay, John

AU - Antonowicz, Stefan

AU - Maynard, Nick

AU - McCormack, Orla

AU - Ariyarathenam, Arun

AU - Sanders, Grant

AU - Cheong, Edward

AU - Jaunoo, Shameen

AU - Allum, William

AU - Van Lanschot, Jan

AU - Nilsson, Magnus

AU - Reynolds, John V

AU - Henegouwen, Mark I van Berge

AU - Hanna, George B

N1 - Funding Information: Mr S.R.M. received the European Society for Medical Oncology Clinical Research Fellowship for the support of this study. Mr S.R.M. is supported by an NIHR Academic Clinical Lectureship and acknowledges support from the National Institute for Health Research (NIHR) Imperial Biomedical Research Centre (BRC). This study was also supported by the NIHR London IVD Co-operative and the Morgagni Charity. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health. Publisher Copyright: © 2022 Wolters Kluwer Health, Inc. All rights reserved.

PY - 2022/2

Y1 - 2022/2

N2 - 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.

AB - 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.

KW - esophageal cancer

KW - quality of life

KW - survivorship

KW - symptoms

UR - https://www.scopus.com/pages/publications/85123199530

U2 - 10.1097/SLA.0000000000003917

DO - 10.1097/SLA.0000000000003917

M3 - Article

C2 - 32404661

SN - 0003-4932

VL - 275

SP - e392-e400

JO - Annals of Surgery

JF - Annals of Surgery

IS - 2

ER -

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

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Keywords

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