OA05.3. Gastrointestinal Symptoms, and Symptoms of Delayed Gastric Conduit Emptying, One Year After Diagnosis of Cancer in the Esophagus

Abstract

Esophageal Cancer: Surgical Treatment of Esophageal Cancer – long term outcomes Comprehensive studies on long-term gastrointestinal functional results including DGCE after gastric conduit reconstruction are lacking. The aim of this study is to describe GI symptoms and symptoms of DGCE in relation to risk factors and global quality of life 1 year after diagnosis of esophageal cancer, in a large cohort. Diagnostic, surgical and follow up data including EORTC QLQ-c30 and QLQ-OG25 patient reported outcome data 1 year after diagnosis, was extracted from the prospective, validated Swedish National Esophageal and Gastric Cancer Registry for the period 01.01.2006-31.05.2025. Cases not reconstructed with a gastric conduit, did not survive 1 year after diagnosis, lacking complete DGCE symptom data or diagnosed after 31.08.2024 were excluded. Baseline data was compared for responders and non-responders to the patient reported outcome questionnaires. Gastrointestinal symptoms were defined as clinically relevant if reported in the upper two levels of the symptom questions. Diagnostic criteria to determine DGCE symptom positivity were based on international Delphi based consensus criteria. DGCE symptom positivity was tested for association with risk factors and global quality of life. Odds-ratios and 95% confidence intervals were calculated for univariate analysis for correlation to baseline data and risk factors and logistic regression used for multivariable analysis. Based on inclusion and exclusion criteria 2253 out of 13544 cases with history of esophageal cancer were included in the study. 1213 cases (53,8%) responded fully to the DGCE symptom questions and were included for symptom analysis. ASA-class, sex and age were similar in the responder and non-responder groups. The most common clinically relevant GI symptom was early satiety reported by 44% of cases. According to study criteria 322 cases (26.6%) were DGCE symptom positive 1 year after diagnosis. Risk of DGCE symptom positivity was not significantly different in females vs males, OR=1.21 CI (0.88-1.66). Cases were divided into 3 age-categories, 63 years and younger, 63-70 years and 71 years and older. Risk of DGCE symptom positivity was significantly higher in the youngest age-category, OR 1.66 CI (1.22-2.26). Further analysis, quality of life data and univariate and multivariate logistic regression results will be presented. This is the first study based on international consensus criteria for DGCE diagnosis using a large prospectively collected nationwide database to report on the incidence of DGCE symptoms and correlation to risk factors. Approximately one fourth of individuals reported DGCE symptom positivity and younger age was associated with increased risk of DGCE symptom positivity. With increasing survival after esophagectomy for cancer, further research focus on DGCE pathophysiology, classification, prevention and treatment is highly justified.