398. DYSPHAGIA OR REGURGITATION AND ITS CORRELATES AMONG UP TO 10-YEAR ESOPHAGEAL SQUAMOUS CELL CARCINOMA SURVIVORS

Abstract

Background Dysphagia and regurgitation significantly impair the quality of life among survivors of esophageal squamous cell carcinoma (ESCC). Notably, the prevalence and associated factors of these symptoms in long-term survivors, particularly within Asian populations, remain underexplored. This study endeavors to bridge these critical knowledge gaps. Methods We evaluated the severity of dysphagia and regurgitation (mild, moderate, and severe), and their associations with clinical features and lifestyle factors among 512 10-year ESCC survivors who underwent ESCC radical surgery. Demographic, clinical, and lifestyle information was collected at study enrollment, which occurred 6 months post-surgery, and dysphagia and regurgitation was assessed at the 10-year post-surgery follow-up survey. Results In this study, 13.3% and 27.0% of participants reported dysphagia and regurgitation, respectively. Multivariable polytomous regression analysis revealed a significant association of dysphagia with upper thoracic esophageal carcinoma (mild dysphagia OR: 2.371, 95% CI: 1.051, 5.347) and postoperative radiotherapy and chemotherapy (mild dysphagia OR: 4.352, 95% CI: 2.168, 8.732; moderate/severe dysphagia OR: 3.651, 95% CI: 1.046, 12.745). An inverse relationship was observed between dysphagia and dietary quality as measured by the CHFP-2007 score (mild dysphagia OR: 0.458, 95% CI: 0.341, 0.615; moderate/severe dysphagia OR: 0.168, 95% CI: 0.089, 0.316). For regurgitation, positive associations were found with higher income level (mild regurgitation OR: 2.074, 95% CI: 1.020, 4.216), insomnia (moderate/severe regurgitation OR: 3.523, 95% CI: 1.127, 11.010), and use of Chinese patent medicine (mild regurgitation OR: 2.264, 95% CI: 1.279, 4.007). Conversely, age at surgery (moderate/severe dysphagia OR: 0.907, 95% CI: 0.848, 0.970) and higher dietary quality (mild dysphagia OR: 0.744, 95% CI: 0.606, 0.914; moderate/severe dysphagia OR: 0.406, 95% CI: 0.259, 0.634) showed protective effects against regurgitation. Conclusions The prevalence of dysphagia and regurgitation among long-term survivors of ESCC in China is high, underscoring a significant health concern. This study identifies critical correlates such as the tumor's anatomical site, the nature of postoperative interventions, dietary quality, socioeconomic standing, and concurrent health issues. These findings advocate for the integration of postoperative management approaches, including tailored dietary and lifestyle adjustments, aimed at mitigating these symptoms in long-term ESCC survivors.