P1.210. Improving Quality of Life in Resectable Oesophageal Cancer Patients Through Perioperative Allied Health Interventions: A Systematic Review

Abstract

Abstract Topic Esophageal Cancer: Surgical Treatment of Esophageal Cancer – early outcomes and complications Background In patients with resectable disease, the 5-year survival is higher, with a rate of 44-52% for those who have undergone an esophagectomy, however there is an overall decline in global health-related quality of life (HRQOL). Perioperative exercise and nutrition interventions, such as prehabilitation, may help to improve HRQOL. Methods A systematic literature search of MEDLINE (OVID), PubMed, CINAHL, Web of Science, Embase and the Cochrane library was performed to identify studies that evaluated HRQOL in resectable oesophageal cancer patients undergoing perioperative exercise and nutrition interventions from RCTs only. Data were extracted and compared narratively but were not able to be meta-analysed. Results A total of 3948 studies were identified, and 34 studies were included in this review. Most of the studies were from China (n=12) or multi-European centres (n=3) and assessed HRQOL using EORTC QLQ-C30 (77%). Nurse-led postoperative rehabilitation programs, particularly those that focused on nutrition, psychological state and symptom management had a significantly positive effect on quality of life (QOL). There is also some evidence that early oral postoperative nutrition can improve HRQOL, but preoperative immunonutrition has no measurable effect. Rehabilitation exercise programs and prehabilitation programs had mixed effects on QOL and failed to definitively positively impact QOL. Conclusion Nurse-led postoperative programs appear to be critical to improving postoperative HRQOL. However, the EORTC QLQ-C30 instrument may not be the best to assess changes in HRQOL after esophagectomy for perioperative exercise and nutrition interventions.