P1.152. Quality of Life Outcomes Post Esophagectomy: a Prospective Study in an Apex Cancer Care Institution
TL;DR
Transthoracic esophagectomy is associated with a transient decline in quality of life followed by progressive recovery and significant improvement by 6 months, with marked relief in dysphagia and related esophageal symptoms.
Abstract
Esophageal Cancer: Other Carcinoma of the esophagus significantly affects quality of life (QOL), particularly due to symptoms such as dysphagia and nutritional compromise. While transthoracic esophagectomy remains a standard curative modality, it is associated with substantial perioperative morbidity. Evaluation of postoperative QOL is essential to understand functional recovery and patient outcomes.
Aim
To study the impact of esophagectomy on health related quality of life (HR QOL) of patients with carcinoma esophagus.
Objectives
1.To determine baseline quality of life in patients with carcinoma esophagus planned for Mckeown’s esophagectomy. 2.To estimate the change in quality of life (QOL) indices over time in patients with carcinoma esophagus who underwent Mckeown’s esophagectomy. METHODOLOGY This prospective study included 50 patients with ECOG performance score of 0-2, who underwent transthoracic (McKeown) esophagectomy.Study was conducted from June 2024 to March 2026. QOL was assessed using EORTC QLQ-C30 and QLQ-OES18, patient administered questionnaires at preoperative, immediate postoperative period(3 week- 4 week), 3 months, and 6 months. Dysphagia was additionally evaluated using the physician administered Modified Takita grading system.Demographic data,disease and treatment related variables were collected from medical records. Statistical analysis included repeated measures ANOVA and Friedman test. The mean age of patients was 59.46 ± 12.32 years, with a male predominance (76%). overall Global QOL showed a significant decline immediately, followed by a recovery at 3 months (48.23) and improvement beyond baseline at 6 months (66.84) (p < 0.001).All functional domains demonstrated a similar pattern of early decline followed by recovery and improvement.Symptom domains showed an inverse trend, with fatigue, pain, and appetite loss worsening postoperatively and improving over time.Esophageal cancer specific domains showed significant improvement, particularly dysphagia (49.17 → 29.55) and eating restriction. Saliva swallowing demonstrated a transient worsening at 3 months before improving at 6 months.Dysphagia assessment using Modified Takita grading showed significant improvement with time (p < 0.001).Subgroup analysis demonstrated significant associations of age, ECOG, and complication severity with postoperative QOL outcomes, while no statistically significant difference was observed with respect to surgical approach or treatment modality. Major complications were associated with poorer early postoperative recovery. Transthoracic esophagectomy is associated with a transient decline in quality of life followed by progressive recovery and significant improvement by 6 months, with marked relief in dysphagia and related esophageal symptoms. Despite early postoperative morbidity, medium-term functional and symptomatic outcomes following McKeown’s esophagectomy are favorable.