Lymphadenectomy and health-related quality of life after oesophageal cancer surgery: a nationwide, population-based cohort study

BMJ Open. 2016 Aug 26;6(8):e012624. doi: 10.1136/bmjopen-2016-012624.

Abstract

Objective: The purpose of this study was to clarify whether more extensive surgical lymph node resection during oesophageal cancer surgery influences patients' health-related quality of life (HRQOL).

Setting: This was a nationwide Swedish population-based study.

Participants: A total of 616 patients who underwent curatively intended oesophageal cancer surgery in 2001-2005 were followed up at 6 months and 5 years after surgery.

Outcome measures: HRQOL was assessed with the validated European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30) and the oesophageal cancer-specific module (EORTC QLQ-OES18). The number of removed lymph nodes in relation to HRQOL was analysed using multivariable linear regression, providing mean score differences in HRQOL scores with 95% CIs. The results were adjusted for age, comorbidity, body mass index, tumour stage, tumour histology, postoperative complications and surgeon volume.

Results: The study included 382 and 136 patients who completed the EORTC questionnaires at 6 months and 5 years following surgery, respectively. In general, HRQOL remained stable over time, with only improvements in role function and appetite loss. A larger number of removed lymph nodes did not decrease the HRQOL measure at 6 months or 5 years after surgery.

Conclusions: More extensive lymphadenectomy during oesophageal cancer surgery might not decrease patients' short-term or long-term HRQOL, but larger studies are needed to establish this potential lack of association.

Keywords: HRQOL; Lymph node; oesophageal neoplasm.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Comorbidity
  • Esophageal Neoplasms / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Linear Models
  • Lymph Node Excision* / adverse effects
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Postoperative Complications / etiology
  • Quality of Life*
  • Surveys and Questionnaires
  • Sweden