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Multicenter Study
. 2025 Feb 1;112(2):znae319.
doi: 10.1093/bjs/znae319.

LAsting Symptoms after Oesophageal Resectional Surgery (LASORS): multicentre validation cohort study

Heidi Paine  1   2 , Swathikan Chidambaram  3 , Asif Johar  4 , Nick Maynard  2 , Pernilla Lagergren  3   4 , Ewen A Griffiths  5 , Paul Behrens  6 , Pritam Singh  7 , Nima Abbassi-Ghadi  7 , Shaun R Preston  7 , Ravinder S Vohra  8 , James Gossage  9 , Tim Underwood  10 , Nick Dai  11 , J Robert O'Neill  11   12 , Sherif Awad  13 , Borzoueh Mohammadi  14 , Khaled Dawas  14 , Yassar Qureshi  14 , Bilal Alkhaffaf  15   16 , Rhys Jones  17 , George B Hanna  3 , Sheraz R Markar  1   2
Affiliations
Multicenter Study

LAsting Symptoms after Oesophageal Resectional Surgery (LASORS): multicentre validation cohort study

Heidi Paine et al. Br J Surg. .

Abstract

Background: Long-term symptom burden and health-related quality-of-life outcomes after curative oesophageal cancer treatment are poorly understood. Existing tools are cumbersome and do not address the post-treatment population specifically. The aim of this study was to validate the six-symptom LASORS tool for identifying patients after curative oesophageal cancer treatment with poor health-related quality of life and to assess its clinical utility.

Methods: Between 2015 and 2019, patients from 15 UK centres who underwent curative-intent oesophageal cancer treatment, and were disease-free at least 1 year after surgery, were invited to participate in the study and complete LASORS and European Organisation for Research and Treatment of Cancer QLQ-C30 and QLQ-OG25 questionnaires. Receiver operating characteristic curve analysis was used to examine the accuracy of the LASORS tool for identifying patients with poor health-related quality of life.

Results: A total of 263 patients completed the questionnaire. Four of the six LASORS symptoms were associated with poor health-related quality of life: reduced energy (OR 2.13 (95% c.i. 1.45 to 3.13)); low mood (OR 1.86 (95% c.i. 1.20 to 2.88)); diarrhoea more than three times a day unrelated to eating (OR 1.48 (95% c.i. 1.06 to 2.07)); and bloating or cramping after eating (OR 1.35 (95% c.i. 1.03 to 1.77)). The LASORS tool showed good diagnostic accuracy with an area under the receiver operating characteristic curve of 0.858 for identifying patients with poor health-related quality of life.

Conclusion: The six-symptom LASORS tool generated a reliable model for identification of patients with poor health-related quality of life after curative treatment for oesophageal cancer. This is the first tool of its kind to be prospectively validated in the post-esophagectomy population. Clinical utility lies in identification of patients at risk of poor health-related quality of life, ease of use of the tool, and in planning survivorship services.

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Figures

Fig. 1
Fig. 1
LASORS tool Symptom-based grading system including prevalence and impact on health-related quality of life; each symptom is then awarded a composite score from zero to five.
Fig. 2
Fig. 2
Receiver operating characteristic curve for LASORS symptoms and health-related quality of life
See this image and copyright information in PMC

References

    1. Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2024;74:229–263 - PubMed
    1. Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA Cancer J Clin 2023;73:17–48 - PubMed
    1. Global Burden of Disease Cancer Collaboration . Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 29 cancer groups, 1990 to 2016: a systematic analysis for the global burden of disease study. JAMA Oncol 2018;4:1553–1568 - PMC - PubMed
    1. van Putten M, de Vos-Geelen J, Nieuwenhuijzen GAP, Siersema PD, Lemmens VEPP, Rosman C et al. Long-term survival improvement in oesophageal cancer in the Netherlands. Eur J Cancer 2018;94:138–147 - PubMed
    1. Bolger JC, Donohoe CL, Lowery M, Reynolds JV. Advances in the curative management of oesophageal cancer. Br J Cancer 2022;126:706–717 - PMC - PubMed