Function and Quality of Life after Esophageal Resection

Abstract

Early detection and resection of esophageal carcinoma provide the best chance for cure¹. Long-term survival is mostly stage dependent^2–4. Five-year survival for resected stage I carcinoma varies between 50 and 85% and for resected stage II between 20% and 50%^1–5. Because the incidence of adenocarcinoma of the esophagus and esophagogastric junction is increasing⁶, endoscopic surveillance for Barrett’s disease will very likely lead to earlier cancer detection and resection and possibly improved long-term survival^7–8. However, little is known of the functional status and quality of life of long-term survivors after curative resection for esophageal carcinoma⁹. Success of curative treatment for esophageal cancer has been traditionally measured with survival. Few reports on quality of life after esophageal resection for cancer have been published. A review of the literature by Gelfand et al in 1992⁹ revealed that of 7,569 publications written on the subject of esophageal carcinoma, only 44 dealt with quality of life (0.58%). Clearly, a better understanding of the functional outcome and quality of life of longterm survivors is needed in this new era of health care Appropriate tools to measure outcome, however, are limited and development of such instruments will become increasingly important in the future if surgeons are to better plan preoperative counseling, surgical approach and postoperative care.