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Multicenter Study
. 2022 Feb 1;275(2):e392-e400.
doi: 10.1097/SLA.0000000000003917.

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

Sheraz R Markar  1   2 , Giovanni Zaninotto  1 , Carlo Castoro  3   4 , Asif Johar  2 , Pernilla Lagergren  1   2 , Jessie A Elliott  5 , Suzanne S Gisbertz  6 , Christophe Mariette  7 , Rita Alfieri  3 , Jeremy Huddy  1 , Viknesh Sounderajah  1 , Eleonora Pinto  3 , Marco Scarpa  3 , Fredrik Klevebro  2 , Berit Sunde  2 , Conor F Murphy  5 , Christine Greene  5 , Narayanasamy Ravi  5 , Guillaume Piessen  7 , Hylke Brenkman  8 , Jelle P Ruurda  8 , Richard Van Hillegersberg  8 , Sjoerd Lagarde  9 , Bas Wijnhoven  9 , Manuel Pera  10 , José Roig  10 , Sandra Castro  10 , Robert Matthijsen  11 , John Findlay  12 , Stefan Antonowicz  12 , Nick Maynard  12 , Orla McCormack  13 , Arun Ariyarathenam  14 , Grant Sanders  14 , Edward Cheong  15 , Shameen Jaunoo  16 , William Allum  13 , Jan Van Lanschot  9 , Magnus Nilsson  17 , John V Reynolds  5 , Mark I van Berge Henegouwen  6 , George B Hanna  1
Affiliations
Multicenter Study

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

Sheraz R Markar et al. Ann Surg. .

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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Conflict of interest statement

The authors report no conflicts of interest.

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