Patients Struggle With Severe Symptoms Even After Surviving Esophagectomy for Esophageal Cancer

Mohamad K Abou Chaar; Anny Godin; Sahar A Saddoughi; William M Harmsen; Minji K Lee; Kathleen J Yost; Shanda H Blackmon

doi:10.1016/j.atssr.2023.09.010

Patients Struggle With Severe Symptoms Even After Surviving Esophagectomy for Esophageal Cancer

Ann Thorac Surg Short Rep. 2023 Nov 3;2(1):98-102. doi: 10.1016/j.atssr.2023.09.010. eCollection 2024 Mar.

Authors

Mohamad K Abou Chaar¹, Anny Godin¹, Sahar A Saddoughi¹, William M Harmsen², Minji K Lee³, Kathleen J Yost^{3

4}, Shanda H Blackmon^{1

5}

Affiliations

¹ Division of Thoracic Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota.
² Department of Biostatistics, Mayo Clinic, Rochester, Minnesota.
³ Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota.
⁴ Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.
⁵ Center for Digital Health, Mayo Clinic, Rochester, Minnesota.

Abstract

Background: This prospective study was conducted to determine postesophagectomy symptom severity of esophageal cancer survivors with use of the Upper Digestive Disease (UDD) questionnaire.

Methods: A prospective trial included adult esophagectomy patients diagnosed with primary esophageal carcinoma at a single institution from 2000 to 2011. Those who remained alive in 2015 to 2021 were enrolled. Comparison was made between sequential questionnaires.

Results: From a prospective registry of 895 patients with esophagectomy for esophageal cancer, 297 (33%) long-term survivors were identified. Of those, 93 (31%) had recent contact data and 66 (71%) consented and completed the UDD questionnaire. Most participants, 77% (51), were men with a mean age of 57 (±7) years. The mean time from esophagectomy was 12 (8-20) years. The 66 enrolled patients completed 127 UDD questionnaires. A total of 27 (41%) completed at least 2 questionnaires. Poor performance was recorded in the 5 domains as follows: reflux, 19 patients (29%); pain, 3 patients (5%); dysphagia, 0 patients; gastrointestinal dumping, 31 patients (47%); and generalized dumping, 17 patients (26%). Between the first and second questionnaires, dysphagia had the most noticeable improvement in domain score (23/27 [85%]), and reflux had the most regression in domain score (7/27 [26%]).

Conclusions: Patient-reported outcome data are an integral part of esophageal cancer survivorship care. Having a standardized tool that would enhance research and standardize care pathway symptom management is needed.