Universität zu Köln

Fuchs, Hans, Hoelscher, Arnulf H., Leers, Jessica, Bludau, Marc, Brinkmann, Sebastian, Schroeder, Wolfgang, Alakus, Hakan, Moenig, Stefan and Gutschow, Christian A. (2016). Long-term quality of life after surgery for adenocarcinoma of the esophagogastric junction: extended gastrectomy or transthoracic esophagectomy? Gastric Cancer, 19 (1). S. 312 - 318. NEW YORK: SPRINGER. ISSN 1436-3305

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Abstract

Esophagectomy with gastric tube reconstruction and extended transhiatal gastrectomy with Roux-en-Y reconstruction are alternative procedures in current therapeutic concepts for adenocarcinoma of the esophagogastric junction (AEG). The impact of these operations on long-term health-related quality of life (HRQL) is incompletely understood. Patients with cancer-free survival of at least 24 months after esophagectomy (ESO) or extended gastrectomy (GAST) for AEG were identified from a prospectively maintained database. EORTC questionnaires were sent out to assess health-related general (QLQ-C30) and cancer-specific (OG-25) quality of life. Numeric scores were calculated for each conceptual area and compared with those of healthy reference populations. 123 patients (ESO n = 71; GAST n = 52) completed the self-rated questionnaires. HRQL was consistently lower in surgical patients (GAST and ESO) compared with healthy reference populations. Also, there was a general trend for a better HRQL in GAST compared with ESO patients. This trend was statistically significant for physical function (p = 0.04), dyspnea (p = 0.02), and reflux (p = 0.03). Subgroup analysis revealed no significant differences between patients with or without prior neoadjuvant therapy. After mid- and long-term follow-up, HRQL after extended gastrectomy with Roux-en-Y reconstruction is superior to that after esophagectomy and gastric tube reconstruction. Improved HRQL after gastrectomy is mainly due to less pulmonary and reflux-related symptoms. Our findings may influence the choice of the surgical strategy for patients with AEG.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Fuchs, Hans UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoelscher, Arnulf H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Leers, Jessica UNSPECIFIED UNSPECIFIED UNSPECIFIED Bludau, Marc UNSPECIFIED UNSPECIFIED UNSPECIFIED Brinkmann, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Schroeder, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED Alakus, Hakan UNSPECIFIED UNSPECIFIED UNSPECIFIED Moenig, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Gutschow, Christian A. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-291993
DOI:	10.1007/s10120-015-0466-3
Journal or Publication Title:	Gastric Cancer
Volume:	19
Number:	1
Page Range:	S. 312 - 318
Date:	2016
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1436-3305
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CANCER; HEALTH; ESOPHAGUS; RESECTION; CLASSIFICATION; SURVIVORS; THERAPY; STOMACH Multiple languages Oncology; Gastroenterology & Hepatology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/29199