Long-Term Quality of Life and Survivorship Priorities in Esophageal Cancer Patients: A Survey-Based Assessment

Background and objectives: This study examines the long-term quality of life (QOL) and priorities of survivors who underwent management for esophageal cancer (EC).

Methods: We cross-sectionally surveyed EC patients through online support groups to assess the relative importance of their overall survival, experience, costs of care, and QOL. Kendall's co-efficient of Concordance (W) was utilized to assess agreement among respondents.

Results: Among 100 respondents (age 57.2 ± 10.4 years, 54% male, 90% Caucasian), median overall survival was 18.0 (7.8-49.8) months, with a maximum survivorship of 48.3 years. Respondents ranked overall survival most important, followed by functional independence, emotional well-being, treatment experience, and costs of care (W = 0.342, p < 0.001). Some survivors ranked treatment experience (4%) or costs (6%) as their most important priority. The cohort's physical QOL (P-QOL; 39.79 ± 10.16) and mental QOL (M-QOL; 42.29 ± 15.43) were below that of the general population (50.00 ± 10.00); both p < 0.050. There was no difference in P-QOL and M-QOL based on the presence of metastatic disease (both p > 0.050). Patients who underwent curative surgery had superior M-QOL (45.00 ± 15.22 vs. 36.70 ± 14.53, p = 0.010). Although P-QOL was similar based on duration of survival (40.30 ± 9.75 [< 1 year], 39.33 ± 10.52 [1-5 years], 39.81 ± 10.68 [> 5 years], p = 0.873), M-QOL was higher in patients with extended survivorship (36.87 ± 14.24 [< 1 year], 45.05 ± 14.94 [1-5 years], 47.30 ± 16.36 [> 5 years], p = 0.008).

Conclusions: Despite enduring physical health impairments, a majority of EC survivors prioritized their survival. However, a few survivors prioritized costs and treatment experience, underscoring the importance of tailoring treatments to ensure alignment with individual patient-driven priorities.