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- Kauppila, JH, et al.
(författare)
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Minimally invasive surgical techniques for oesophageal cancer and nutritional recovery: a prospective population-based cohort study
- 2022
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Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 12:9, s. e058763-
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Tidskriftsartikel (refereegranskat)abstract
- To explore whether the minimally invasive oesophagectomy (MIE) or hybrid minimally invasive oesophagectomy (HMIE) are associated with better nutritional status and less weight loss 1 year after surgery, compared with open oesophagectomy (OE).DesignProspective cohort study.SettingAll patients undergoing oesophagectomy for cancer in Sweden during 2013–2018.ParticipantsA total of 424 patients alive at 1 year after surgery were eligible, and 281 completed the 1-year assessment. Of these, 239 had complete clinical data and were included in the analysis.Primary and secondary outcome measuresThe primary outcome was nutritional status at 1 year after surgery, assessed using the abbreviated Patient-Generated Subjective Global Assessment questionnaire. The secondary outcomes included postoperative weight loss at 6 months and 1 year after surgery.ResultsOf the included patients, 78 underwent MIE, 74 HMIE while 87 patients underwent OE. The MIE group had the highest prevalence of malnutrition (42% vs 22% after HMIE vs 25% after OE), reduced food intake (63% vs 45% after HMIE vs 39% after OE), symptoms reducing food intake (60% vs 45% after HMIE vs 60% after OE) and abnormal activities/function (45% vs 32% after HMIE vs 43% after OE). After adjustment for confounders, MIE was associated with a statistically significant increased risk of reduced food intake 1 year after surgery (OR 2.87, 95% CI 1.47 to 5.61), compared with OE. Other outcomes were not statistically significantly different between the groups. No statistically significant associations were observed between surgical techniques and weight loss up to 1 year after surgery.ConclusionsMIE was statistically significantly associated with reduced food intake 1 year after surgery. However, no differences were observed in weight loss between the surgical techniques. Further studies on nutritional impact of surgical techniques in oesophageal cancer are needed.
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- Schandl, AR, et al.
(författare)
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Education level and health-related quality of life after oesophageal cancer surgery: a nationwide cohort study
- 2018
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Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 8:8, s. e020702-
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of the study was to investigate whether low education level was associated with patients’ health-related quality of life (HRQOL) after oesophageal cancer resection.SettingA nationwide cohort study in Sweden.ParticipantsIn total, 378 patients who underwent oesophageal cancer surgery in 2001–2005 were followed up 6 months and 3 years after surgery.Outcome measuresHRQOL was assessed by the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (QLQ-C30) and the oesophageal cancer-specific module. The association between level of education and HRQOL was calculated with linear regression models, providing mean score differences (MD) and 95% CIs. Data were analysed separately for women and men.ResultsEducation level was not associated with HRQOL recovery after oesophageal cancer surgery. However, when data were stratified by sex, lower education was associated with worse emotional function (MD −13; 95% CI −22 to −3), more symptoms of insomnia (MD 20; 95% CI 8 to 32) and reflux (MD: 15; 95% CI 3 to 26) for women, but not for men. Among women, low education was in general associated with worse functioning and more symptoms.ConclusionsLow education was not associated with worse HRQOL after oesophageal cancer surgery. However, when data were stratified for sex, low education level was associated with worse functioning and more symptoms in certain HRQOL domains for women, particularly in a short-term perspective. For men, no such association was found.
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