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Esophageal Resection for Cancer of the Esophagus: Long-Term Function and Quality of Life
Open accessAbstract
Background Information on function and quality of life of long-term survivors after esophageal resection for carcinoma is limited. Methods Between 1972 and 1990, 359 patients underwent esophagectomy for stage I or II esophageal carcinoma at Mayo Clinic. We evaluated long-term function and quality of life in 107 of these patients (81 men and 26 women) who survived 5 or more years. Median age at operation was 62 years (range, 30 to 81 years). The operation performed was an Ivor Lewis resection in 77 patients (72%), transhiatal esophagectomy in 14 (13%), extended esophagectomy in 4 (4%), thoracoabdominal esophagectomy in 4 (4%), and other in 8 (7%). Adenocarcinoma was present in 72 patients (67%), squamous cell carcinoma in 28 (26%), and other in 7 (7%). Thirty-four patients (32%) were in postsurgical stage I, 65 (61%) in stage IIA, and 8 (8%) in stage IIB. Median survival was 10.2 years (range, 5.0 to 23.2 years). Follow-up was complete for all patients. Results Gastroesophageal reflux was present in 64 patients (60%), symptoms of dumping in 53 (50%), and dysphagia to solid food in 27 (25%). Seventeen patients (16%) were asymptomatic. Factors affecting late functional outcome were analyzed. Patients who had a cervical anastomosis had significantly fewer reflux symptoms (p < 0.05). Dumping syndrome occurred more frequently in younger patients (p < 0.05) and women (p < 0.01). Quality of life was assessed separately by the Medical Outcomes Study 36-Item Short-Form Health Survey and compared with the national norm. Scores measuring physical functioning were decreased (p < 0.01). Scores measuring ability to work, social interaction, daily activities, emotional dysfunction, perception of health, and levels of energy were similar. Mental health scores were higher (p < 0.05). Conclusions We conclude that long-term functional outcome after esophagectomy for esophageal carcinoma is affected by age, sex, and type of reconstruction. Quality of life as judged by the patients is similar to the national norm.
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“Dumping syndrome, a common complication of esophageal, gastric or bariatric surgery, includes early and late dumping symptoms.”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [4]
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“Dumping syndrome has been reported to occur in approximately 20% of patients who undergo vagotomy with pyloroplasty, in up to 40% of patients after Roux-en-Y gastric bypass or sleeve gastrectomy, and in up to 50% of patients who undergo esophagectomy (3)(4)(5)(6)(7).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [4]
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“of Ivor-Lewis esophagectomy, however, is anastomotic stricture, with postoperative rates of dysphagia to solid foods quoted at 25% to 35%.(67,68) When PEG or NGT feeding fails to prevent aspiration events, more radical measures may be required to prevent aspiration, such as”
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“Häufig manifestiert sich die Symptomatik auch atypisch im Sinne von Hustenattacken, insbesondere im Liegen oder postprandial.”
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“However, patients with cervical anastomosis have been reported to experience significantly fewer reflux symptoms.(12) To our knowledge, no study has directly compared Ivor Lewis esophagectomy and McKeown esophagectomy in esophagogastric junction cancer patients.”
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“Nombre de dilatations successives (sans autre intervention associée), nombre (%) 1 16 (23%) 2 25 (35%) 3 12 (17%) 4 5 (7%) 5 5 (7%) 6 à 10 6 (8%) 11 à 13 2 (3%) Utilisation de bougies au moins une fois, nombre (%) 36 (51%) Utilisation de ballon au moins une fois, nombre (%) 49 (69%) Diamètre maximum de dilatation, méd…”
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Metadata
- Authors
- McLarty, A. J., Deschamps, C., Trastek, V. F., Allen, M. S., Pairolero, P. C., & Harmsen, W. S.
- Affiliations
- Mayo Clinic (US)
- Corresponding author
- Deschamps, Claude
- Venue
- The Annals of Thoracic Surgery
- Publisher
- Elsevier BV
- Published
- 1997-06
- Volume
- 63
- Issue
- 6
- Pages
- 1568-1571
- ISSN
- 0003-4975 (ISSN-L)
- OpenAlex
- W2094315259
- Cited by
- 272
- References
- 0
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 4 · 2023: 5 · 2022: 7 · 2021: 5 · 2020: 11 · 2019: 9 · 2018: 5 · 2017: 7 · 2016: 8 · 2015: 14 · 2014: 7 · 2013: 15 · 2012: 17
- FWCI
- 4.89
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Annals of Thoracic Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Esophageal Cancer Research and Treatment
- Health Sciences › Medicine › Surgery › Esophageal and GI Pathology
- Health Sciences › Medicine › Oncology › Gastric Cancer Management and Outcomes
- Keywords
- esophageal cancer, esophagectomy, long-term functional outcome, quality of life, gastroesophageal reflux, dumping syndrome, dysphagia, cervical anastomosis, esophageal reconstruction, adenocarcinoma, squamous cell carcinoma, physical function, age and sex effects, late complications, long-term survivors, SF-36
- MeSH terms
- Actuarial Analysis, Adenocarcinoma, Adult, Age Factors, Aged, Aged, 80 and over, Carcinoma, Squamous Cell, Cause of Death, Deglutition, Deglutition Disorders, Esophageal Neoplasms, Female, Follow-Up Studies, Heartburn, Humans, Male, Middle Aged, Neoplasm Staging, Quality of Life, Sex Factors, Survival Rate, Confidence Intervals, Esophagectomy
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