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Cancers 2018, 10(9), 318; https://doi.org/10.3390/cancers10090318

Nutrition Impact Symptoms Are Prognostic of Quality of Life and Mortality After Surgery for Oesophageal Cancer

1
Surgical Care Sciences, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, 171 76 Stockholm, Sweden
2
Department of Biosciences and Nutrition, Karolinska Institutet, 171 76 Stockholm, Sweden
3
Function Area Clinical Nutrition, Karolinska University Hospital, 141 86 Stockholm, Sweden
4
Department of Medicine, Solna, Karolinska Institutet, 171 76 Stockholm, Sweden
5
Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK
*
Author to whom correspondence should be addressed.
Received: 22 July 2018 / Revised: 28 August 2018 / Accepted: 4 September 2018 / Published: 7 September 2018
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Abstract

We aimed to clarify the influence of nutritional problems after surgery for oesophageal cancer on functional health related quality of life (HRQOL) and survival. A prospective nationwide cohort of oesophageal cancer patients operated 2001–2005 in Sweden with 6 months postoperative follow up was used. Nutritional problems were categorized as low/moderate/severe/very severe based on weight loss and nutrition impact symptoms. An ANCOVA model calculated mean score differences (MD) with 95% confidence intervals (CI) of global quality of life (QOL), social and physical function scores, stratified by preoperative body mass index (BMI) <25 and ≥25. A Cox proportional hazards model produced hazard ratios (HR) with 95% CI for overall 5-year survival. Of 358 patients, 196 (55%) had preoperative BMI ≥25. Very severe and severe nutritional problems were associated with worse HRQOL in both BMI groups. E.g. MD’s for global QOL among ‘very severe’ group was −29 (95% CI −39–−19) and −20 (95% CI −29–−11) for <25 and ≥25 BMI, respectively, compared to the ‘low’ group. Overall 5-year survival among ‘very severe’ and BMI ≥ 25 was worse; HR 4.6 (95% CI 1.4–15.6). Intense nutritional problems negatively impact postoperative HRQOL and combined with preoperative BMI ≥ 25 are associated with poorer 5-year overall survival representing a group needing greater clinical attention. View Full-Text
Keywords: oesophageal neoplasms; quality of life; survival; nutrition impact symptoms; oesophagectomy oesophageal neoplasms; quality of life; survival; nutrition impact symptoms; oesophagectomy
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Anandavadivelan, P.; Martin, L.; Djärv, T.; Johar, A.; Lagergren, P. Nutrition Impact Symptoms Are Prognostic of Quality of Life and Mortality After Surgery for Oesophageal Cancer. Cancers 2018, 10, 318.

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