Esophageal Cancer Surgery Can Result in Clustered Symptoms
Symptoms Cluster After Esophageal Cancer Surgery
(HealthDay News) -- For surgically treated patients with esophageal cancer, symptoms appear to cluster together, and these clusters are strongly associated with mortality, according to a study published online Nov. 25 in Cancer.
Anna Wikman, Ph.D., from the Karolinska Institutet in Stockholm, and colleagues used data from a prospective Swedish cohort of surgically treated patients with esophageal cancer to examine whether symptoms cluster together after surgery. The European Organization for Research and Treatment of Cancer QLQ-C30 quality of life questionnaire and the QLQ-OES18 module were used to assess general and esophageal-cancer-specific symptoms at six months after surgery.
The researchers identified three clusters of symptoms among 402 patients reporting symptoms six months after surgery. The clusters were "fatigue/pain," characterized by symptoms of pain, fatigue, insomnia, and dyspnea; "reflux/cough," characterized by symptoms of dry mouth, taste problem, coughing, and reflux; and "eating difficulties," characterized by symptoms of appetite loss, dysphagia, eating difficulties, and nausea/vomiting. The clusters were present in 30, 27, and 28 percent of patients, respectively. The risk of mortality was significantly increased with the presence of reflux/cough (adjusted hazard ratio, 1.43) and eating difficulties (adjusted hazard ratio, 1.41) symptom clusters.
"Symptoms experienced by surgically treated patients with esophageal cancer at six months after surgery appear to cluster together, and these clusters have strong prognostic value," the authors write.