Quality of life and survival of achieving textbook outcome for resectable esophageal squamous cell carcinoma.

BACKGROUND

The relationship between textbook outcome (TO) and health-related quality of life (QOL) is unclear. Our purpose is to investigate the relationship between achieving TO and survival and postoperative QOL in individuals with esophageal squamous cell carcinoma (ESCC).

METHODS

We conducted analyses of consecutive patients with ESCC who underwent minimally invasive McKeown esophagectomy in a single center from April 2019 to December 2020. The patients were grouped into a TO group and a non-TO group. The longitudinal QOL was handled using a linear mixed effect model. The European Organization for Research and Treatment of Cancer (EORTC) questionnaires were used to assess symptoms and QOL.

RESULTS

One hundred and twenty-three patients (33.3%) achieved TO. Postoperative complications and insufficient lymph node dissection were the main reasons that hindered achieving TO. In the EORTC Quality of Life Questionnaire Core-30 (EORTC QLQ-C30) and EORTC Quality of Life Esophagus-specific Questionnaire (EORTC QLQ-S18) scales, compared to the non-TO group, the TO group reported worse social function, more financial impact, less trouble with taste, milder dysphagia and better disease-free survival (DFS) and overall survival (OS).

CONCLUSIONS

Patients who could achieve the TO might experience a milder dysphagia symptom, better DFS and OS in the short term after esophagectomy. The postoperative management of the patients who can achieve the TO should be strengthened to improve the postoperative QOL.