P1.208. Long-Term Health Related Quality of Life Following Curative Treatment for Esophageal Cancer: A Systematic Review and Meta-Analysis

Abstract

Abstract Topic Esophageal Cancer: Surgical Treatment of Esophageal Cancer – long term outcomes Background Treatment for esophageal cancer has a significant impact on health-related quality of life (HRQoL). Advances in treatment have resulted in improved survival rates, and the need to improve patient quality of life. This review summarizes the evidence on the impact of various treatments on long-term quality of life in order to inform practice. 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 quality of life at least 3 years following curative treatment. Data were extracted and compared narratively and in a meta-analysis, using odds ratio and mean differences with 95% confidence intervals. Results A total of 11,618 studies were identified, and 31 studies were included in this review. Most of the studies were from Sweden (n=15) or China (n=5). HRQoL in most studies (90%) was assessed using the EORTC QLQ-C30 in combination with the esophageal cancer add-on, QLQ-OES18. Narrative synthesis revealed that most aspects of HRQoL recovered to preoperative levels at the 3-year assessment. Four studies applying QLQ-C30 were included in the meta-analysis: global quality of life had a mean difference of 3.08 (95% CI 0.2-5.96) and an effect size equaling 2 (p<0.04). Twelve out of the fifteen domains showed differences between cancer patients and reference healthy individuals. Diarrhea had the highest mean difference, worse in esophageal cancer patients compared to reference healthy population (-15.87; 95% CI -21.9 to -9.84) and the largest effect size (5.16, p <0.00001) but had significant heterogeneity (I2 = 66%, p<0.03). Conclusion Overall, the quality of life for esophageal cancer survivors should be a key focus for clinicians given its association with treatment outcomes and overall survival. There was evidence that some aspects of HRQoL recovered by 3-years but some impacts were longer lasting.