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Quality of Life and Late Complications After Minimally Invasive Compared to Open Esophagectomy: Results of a Randomized Trial.

Maas KW, Cuesta MA, van Berge Henegouwen MI, Roig J, Bonavina L, Rosman C, Gisbertz SS, Biere SS, van der Peet DL, Klinkenbijl JH, Hollmann MW, de Lange ES, Bonjer HJ - World J Surg (2015)

Bottom Line: Non-randomized studies investigating the mid-term quality of life after MIE show conflicting results at 1-year follow-up.Quality of life at 1 year was better in the MIE group than in the OE group for the physical component summary SF36 [50 (6; 48-53) versus 45 (9; 42-48) p .003]; global health C30 [79 (10; 76-83) versus 67 (21; 60-75) p .004]; and pain OES18 module [6 (9; 2-8) versus 16 (16; 10-22) p .001], respectively.Twenty six patients (44%) in the MIE and 22 patients (39%) in the OE group were diagnosed and treated for symptomatic stenosis of the anastomosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, VU University Medical Center, Amsterdam, The Netherlands.

ABSTRACT

Background: The minimally invasive esophagectomy (MIE) is widely being implemented for esophageal cancer in order to reduce morbidity and improve quality of life. Non-randomized studies investigating the mid-term quality of life after MIE show conflicting results at 1-year follow-up. Therefore, the aim of this study is to determine whether MIE has a continuing better mid-term 1-year quality of life than open esophagectomy (OE) indicating both a faster recovery and less procedure-related symptoms.

Methods: A one-year follow-up analysis of the quality of life was conducted for patients participating in the randomized trial in which MIE was compared with OE. Late complications as symptomatic stenosis of anastomosis are also reported.

Results: Quality of life at 1 year was better in the MIE group than in the OE group for the physical component summary SF36 [50 (6; 48-53) versus 45 (9; 42-48) p .003]; global health C30 [79 (10; 76-83) versus 67 (21; 60-75) p .004]; and pain OES18 module [6 (9; 2-8) versus 16 (16; 10-22) p .001], respectively. Twenty six patients (44%) in the MIE and 22 patients (39%) in the OE group were diagnosed and treated for symptomatic stenosis of the anastomosis.

Conclusions: This first randomized trial shows that MIE is associated with a better mid-term one-year quality of life compared to OE.

No MeSH data available.


Related in: MedlinePlus

Trial profile MIE minimally invasive esophagectomy, WHO-ECOG World Health Organization- Eastern Cooperative Oncology Group, QoL quality of life. Analysis: intention-to-treat
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Related In: Results  -  Collection


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Fig1: Trial profile MIE minimally invasive esophagectomy, WHO-ECOG World Health Organization- Eastern Cooperative Oncology Group, QoL quality of life. Analysis: intention-to-treat

Mentions: We randomly assigned 115 of 144 eligible patients to receive either OE or MIE. Four crossovers occurred: two patients assigned to the OE group underwent MIE, and two assigned to MIE developed a WHO-ECOG score of 3 during neoadjuvant treatment and were treated by transhiatal esophagectomy. Eight patients did not undergo a resection (Fig. 1); we included these patients in the analysis of the allocated group according to the intention-to-treat principle. Fifty-six patients were analysed in the OE group and 59 in the MIE group. The demographic and clinical characteristics of the two groups were similar at baseline (Table 1). The short-term results are reported elsewhere [5].Fig. 1


Quality of Life and Late Complications After Minimally Invasive Compared to Open Esophagectomy: Results of a Randomized Trial.

Maas KW, Cuesta MA, van Berge Henegouwen MI, Roig J, Bonavina L, Rosman C, Gisbertz SS, Biere SS, van der Peet DL, Klinkenbijl JH, Hollmann MW, de Lange ES, Bonjer HJ - World J Surg (2015)

Trial profile MIE minimally invasive esophagectomy, WHO-ECOG World Health Organization- Eastern Cooperative Oncology Group, QoL quality of life. Analysis: intention-to-treat
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4496501&req=5

Fig1: Trial profile MIE minimally invasive esophagectomy, WHO-ECOG World Health Organization- Eastern Cooperative Oncology Group, QoL quality of life. Analysis: intention-to-treat
Mentions: We randomly assigned 115 of 144 eligible patients to receive either OE or MIE. Four crossovers occurred: two patients assigned to the OE group underwent MIE, and two assigned to MIE developed a WHO-ECOG score of 3 during neoadjuvant treatment and were treated by transhiatal esophagectomy. Eight patients did not undergo a resection (Fig. 1); we included these patients in the analysis of the allocated group according to the intention-to-treat principle. Fifty-six patients were analysed in the OE group and 59 in the MIE group. The demographic and clinical characteristics of the two groups were similar at baseline (Table 1). The short-term results are reported elsewhere [5].Fig. 1

Bottom Line: Non-randomized studies investigating the mid-term quality of life after MIE show conflicting results at 1-year follow-up.Quality of life at 1 year was better in the MIE group than in the OE group for the physical component summary SF36 [50 (6; 48-53) versus 45 (9; 42-48) p .003]; global health C30 [79 (10; 76-83) versus 67 (21; 60-75) p .004]; and pain OES18 module [6 (9; 2-8) versus 16 (16; 10-22) p .001], respectively.Twenty six patients (44%) in the MIE and 22 patients (39%) in the OE group were diagnosed and treated for symptomatic stenosis of the anastomosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, VU University Medical Center, Amsterdam, The Netherlands.

ABSTRACT

Background: The minimally invasive esophagectomy (MIE) is widely being implemented for esophageal cancer in order to reduce morbidity and improve quality of life. Non-randomized studies investigating the mid-term quality of life after MIE show conflicting results at 1-year follow-up. Therefore, the aim of this study is to determine whether MIE has a continuing better mid-term 1-year quality of life than open esophagectomy (OE) indicating both a faster recovery and less procedure-related symptoms.

Methods: A one-year follow-up analysis of the quality of life was conducted for patients participating in the randomized trial in which MIE was compared with OE. Late complications as symptomatic stenosis of anastomosis are also reported.

Results: Quality of life at 1 year was better in the MIE group than in the OE group for the physical component summary SF36 [50 (6; 48-53) versus 45 (9; 42-48) p .003]; global health C30 [79 (10; 76-83) versus 67 (21; 60-75) p .004]; and pain OES18 module [6 (9; 2-8) versus 16 (16; 10-22) p .001], respectively. Twenty six patients (44%) in the MIE and 22 patients (39%) in the OE group were diagnosed and treated for symptomatic stenosis of the anastomosis.

Conclusions: This first randomized trial shows that MIE is associated with a better mid-term one-year quality of life compared to OE.

No MeSH data available.


Related in: MedlinePlus