QOLEC2: a randomized controlled trial on nutritional and respiratory counseling after esophagectomy for cancer

Abstract

Background: Esophagectomy for cancer strongly impairs quality of life. The aim of this trial was to evaluate the effect of the nutritional and respiratory counseling on postoperative quality of life.

Methods: At hospital discharge, patients were randomized into four groups receiving respectively: nutritional and respiratory counseling, nutritional counseling alone, respiratory counseling alone, or standard care. The main endpoint was the impairment in quality of life in the first month after surgery. Linear mixed effect models were estimated to assess mean score differences (MDs) in quality of life scores.

Results: Patients receiving nutritional counseling reported less appetite loss (MD - 17.7, 95% CI - 32.2 to -3.3) than those not receiving nutritional counseling at 1 month after surgery. Dyspnea was similar between patients receiving vs. those not receiving respiratory counseling (MD - 3.1, 95% CI - 10.8 to 4.6). Global quality of life was clinically similar between patients receiving vs. those not receiving nutritional counseling over time (MD 0.9, 95% CI - 5.5 to 7.3), as well as in patients receiving vs. those not receiving respiratory counseling over time (MD 0.7, 95% CI - 5.9 to 7.2).

Conclusions: Intensive postoperative care does not affect global quality of life even if nutritional counseling reduced appetite loss.

Keywords: Esophageal cancer; Esophagectomy; Nutritional counseling; Quality of life; Randomized controlled trial.

Fig. 1

Patients’ allocations

Fig. 2

Scheme and timing of the interventions