Systematic review of health-related quality of life after esophagectomy for esophageal cancer

Table 1 Studies characteristics: Aims of the studies and timing of health-related quality of life recording

Sudy	Study aim	Timing post op HRQL measures
McLarty et al[54]	Analysis of HRQL in long term survivors after surgery alone	A single assessment > 60 mo
De Boer et al[53]	Analysis of HRQL in long term survivors after transhiatal esophagectomy	A single assessment 3.5 (2.1-5.4) yr
Headrick et al[49]	Analysis of HRQL in long term survivors after esophagectomy for HGD or adenocarcinoma	A single assessment 5.3 (0.5-9) yr
Cense et al[52]	Analysis of HRQL in long term survivors after esophagocolonplasty	A single assessment 35 (7-97) mo
Moraca et al[50]	Analysis of HRQL in long term survivors after esophagectomy for HGD or Tis	A single assessment 4.9 (0.5-12) yr
Reynolds et al[55]	Comparison between HRQL after neoadjuvant CT-RT+ surgery and after surgery alone	Baseline, after CT-RT, 3, 6, 9, 12 mo po
Avery et al[56]	Comparison between HRQL after neoadjuvant CT-RT+ surgery and after definitive CT-RT	1, 5, 3, 6, 9 mo
van Meerten et al[57]	Analysis of HRQL after neoadjuvant CT-RT + surgery	Baseline, after CT-RT, 3, 6, 9, 12 mo po
Wang et al[59]	Comparison between open surgery and minimally invasive esophagectomy	2, 4, 12, 24 wk
Parameswaran et al[58]	Analysis of HRQL after minimally invasive esophagectomy	6, 12 mo
Viklund et al[45]	Analysis of HRQL predictors after esophagectomy for cancer (type of recstruction)	A single assessment 6 mo
Rutegard et al[46]	Analysis of HRQL predictors after esophagectomy for cancer (type of recstruction)	A single assessment 6 mo
Rutegard et al[47]	Analysis of HRQL predictors after esophagectomy for cancer (type of recstruction)	A single assessment 6 mo
Olsen et al[60]	Analysis of HRQL in long term survivors (surgery alone or neoadjuvant CT-RT + surgery)	A single assessmentat 24 mo po
Lagergren et al[61]	Analysis of HRQL in long term survivors (surgery alone or neoadjuvant CT-RT + surgery)	Baseline and 36 mo
Djarv et al[62]	Analysis of HRQL in long term survivors (surgery alone or neoadjuvant CT-RT + surgery)	6, 36 mo
Courrech Staal et al[63]	Analysis of HRQL in long term survivors (surgery alone or neoadjuvant CT-RT + surgery)	A single assessment at 54 (16–162) mo
Blazeby et al[64]	Comparison between HRQL after surgery alone and after palliative RT	A single assessment 16 (10-24) wk
Ariga et al[65]	Comparison between surgery alone and definitive CT-RT + salvage surgery	A single assessment 24 mo
Schneider et al[48]	Comparison between HRQL after emergency and elective esophagectomy	1 wk and 9 mo
Rosmolen et al[51]	Comparison between HRQL after endoscopical ablation and esophagectomy for early Barrett’s neoplasms	A single assessment at 24 (17–35) mo

The 21 studies included in the analysis are listed according their aim and then chronologically. HRQL: Health-related quality of life; HGD: High grade dysplasia; CT-RT: Chemotherapy-radiotherapy; op: Operative; po: Post-operative.

Table 2 Studies characteristics: Studies setting and feature

Study	Year	Country	Center	Prospective	Consecutive	HRQL as primaryendpoint	PreoperativeHRQLassessment	SF36	OES18 /OES24	QLQ C30	Populationbased study
McLarty et al[54]	1997	United States	Mayo Clinic, Rochester MI	No	Yes	No	No	Yes	No	No	No
De Boer et al[53]	2000	Netherlands	Academic Medical Centre, Amsterdam	No	No	Yes	No	Yes	No	No	No
Headrick et al[49]	2002	United States	Mayo Clinic, Rochester MI	No	Yes	No	No	Yes	No	No	No
Cense et al[52]	2004	Netherlands	Academic Medical Centre, Amsterdam	No	No	Yes	No	Yes	No	No	No
Moraca et al[50]	2006	United States	Virginia Mason Medical Centre, Seattle	No	Yes	No	No	Yes	No	No	No
Reynolds et al[55]	2006	Ireland	St James's Hospital, Dublin	Yes	Yes	Yes	Yes	No	No	Yes	No
Avery et al[56]	2007	United Kingdom	University of Bristol, Bristol	Yes	Yes	Yes	Yes	No	Yes	Yes	No
van Meerten et al[57]	2008	Netherlands	Erasmus University, Rotterdam	Yes	Yes	Yes	Yes	No	Yes	Yes	No
Wang et al[59]	2009	China	Fudan University, Shanghai	Yes	Yes	Yes	Yes	No	Yes	Yes	No
Parameswaran et al[58]	2010	United Kingdom	Royal Devon and Exeter NHS Trust, Exeter	Yes	Yes	Yes	Yes	No	Yes	Yes	No
Viklund et al[45]	2005	Sweden	Karolinska Institute, Stockholm	Yes	Yes	Yes	No	No	Yes	Yes	Yes
Rutegard et al[46]	2008	Sweden	Karolinska Institute, Stockholm	Yes	No	Yes	No	No	Yes	Yes	Yes
Rutegard et al[47]	2008	Sweden	Karolinska Institute, Stockholm	Yes	No	Yes	No	No	Yes	Yes	Yes
Olsen et al[60]	2005	Sweden	Sahlgrenska University Hospital, Goteborg	No	Yes	No	No	No	Yes	Yes	No
Lagergren et al[61]	2007	United Kingdom	University of Bristol, Bristol	Yes	Yes	Yes	Yes	No	Yes	Yes	Yes
Djarv et al[62]	2008	Sweden	Karolinska Institute, Stockholm	Yes	Yes	Yes	No	No	Yes	Yes	Yes
Courrech Staal et al[63]	2010	Netherlands	Netherlands Cancer Institute, Amsterdam	Yes	Yes	Yes	No	No	Yes	Yes	No
Blazeby et al[64]	1995	United Kingdom	University of Bristol, Bristol	No	Yes	Yes	No	No	No	Yes	No
Ariga et al[65]	2009	Japan	University of Yamaga, Yamaga	Yes	Yes	No	No	No	Yes	Yes	No
Schneider et al[48]	2010	Germany	University of Heidelberg, Heidelberg	Yes	Yes	Yes	Yes	No	Yes	Yes	No
Rosmolen et al[51]	2010	Netherlands	Academic Medical Center, Amsterdam	No	Yes	Yes	No	Yes	Yes	Yes	No

The 21 studies included in the analysis are listed according their aim and then chronologically. HRQL: Health-related quality of life; SF36: Short form-36.

Table 3 Patient characteristics

Study	Patients	Median/1mean age (range)	Recruitment period	Adenocarcinoma	Squamous cell carcinoma	Tis/ HGD/ pCR	Stage I	Stage II	Stage III	Stage IV	Lower esophagus or cardias	Medium or upper esophagus	Mean/1median follow up (mo)	Esophago-gastroplasty	Esophago-colonplasty	Esophago-jejeunoplasty	Neoadjuvant treatment	Adjuvant RT/CT/CT+RT
McLarty et al[54]	107	62 (30-81)	1972-1990	72	28	0	34	73	0		62	45	> 60	99	3	4	0	9
De Boer et al[53]	35	66.41 (42-87)	1993-1996	27	6	2	14	1	18		32	3	> 24	35	0		0
Headrick et al[49]	54	64 (36-83)	1991-1997	53	1	5/35	7	2	5		54	0	63.61 (6-108)
Cense et al[52]	14	69.9 (51-81) ECP, 66.4 (42-87) EGP	1993-2002	6	7	1	8	3	2		10	3	35 (7-97)	0	14
Moraca et al[50]	36	661 (43-88)	1991-2003	35	0	12/24	12						58.8 (6-144)	36	0	0	0	0
Subtotal	246 (14-107)			193	42	3	75	79	25	0	158	51	0	170	17	4	0	9
Reynolds et al[55]	107	61 (29-79)	1999-2004	34	68		25	63	83	3			3				87	87
Avery et al[56]	94	62.41	2000-2004	64	17			14	67				1.5				69	69
van Meerten et al[57]	54	59 (40-75)	2001-2004	41	12	13	12	6	16	5	49	5	3				54	54
Subtotal	255 (54-107)			239	97	13	37	83	166	8	49	5	7.5	0	0	0	210	210
Wang et al[59]	56	60.7 ± 9.3 VATS 58.2 ± 11.5 open	2007-2008	3	52		11	37	8		10	46	6	56			0
Parameswaran et al[58]	62	67 (49-80)	2005-2007	57	5	3	7	21	27	4			12 ± 0.5	62			48
Subtotal	118 (56-62)			60	57	3	18	58	35	4	10	46	6	118	0	0	48	0
Viklund et al[45]		64 (34-84)1	2001-2003										6					16
Rutegard et al[46]		91 pts < 60, 127 pts 60-70, 137 pts >70	2001-2005										6				37
Rutegard et al[47]	355	91 pts < 60, 127 pts 60-70, 137 pts > 70	2001-2005	271	84		81	120	133	18	302	53	6				37
Subtotal	355
Olsen et al[60]	18	62.5 (20-76)	1997-2001			3	5	1	9				24	13	4	1	8	8
Lagergren et al[61]	47	63 (44-79)	2000-2003	35	9	8	10	23	6		23	24	> 36				29
Djarv et al[62]	87	27 pts < 60, 28 pts 60-70, 32 pts > 70	2001-2007	68	19		34	36	13	3	75	12	> 36	69	2	16
Courrech Staal et al[63]	36		2009	22	14	0	4	12	12	8	28	8	54 (range, 16–162)				21
Subtotal	188 (18-87)			125	42	8	53	72	40	11	126	44		82	6	17	58	8
Blazeby et al[64]	33	64 (62-76)	1993-1994	19	14								4 (2.5-6)				0
Ariga et al[65]	48	65.5 (46-78)	2001-2004	0	48		10	15	23		20	28	41.2 (95% CI: 35.1-47.2)
Schneider et al[48]	12	59	2001-2005	1	11								> 9	10	2
Rosmolen et al[51]	27	63.0 (9.5)	2001-2005	27	0	2	19	6					24 (IQR 17 – 35)	23	4		0	0
Subtotal	120 (12-48)			47	73	2	29	21	23	0	20	28		33	6	0	0	0

The 21 studies included in the analysis are listed according their aim and then chronologically. pts: Patients; ECP: Esophagocolonplasty; EGP: Esophagogastroplasty; VATS: Video assisted thoracoscopy; CI: Confidence interval; HGD: High grade dysplasia; pCR: Pathological complete response; RT: Radiotherapy; CT: Chemotherapy; IQR: Interquartile range.