Postoperative complications and health-related quality of life after oesophageal cancer surgery: a national, population-based cohort study.

Abstract

Background and purpose: Surgical resection for oesophageal cancer is technically challenging and associated with a high incidence of complications. This study aimed to assess whether complications influence long-term health-related quality of life (HRQL) in oesophageal cancer survivors.

Materials and methods: This nationwide cohort study included 617 patients who underwent oesophagectomy for cancer in Sweden between 2013 and 2021 with a 1-year follow-up. Complications within 30 days of surgery were categorised into (1) with or without, (2) medical or surgical and (3) according to the Clavien-Dindo classification (0-1, 2-3a, 3b-4). HRQL was assessed with European Organisation for Research and Treatment questionnaires and analysed using multivariable linear regression models, proving mean score differences (MSD) with 95% confidence intervals. The MSDs were adjusted for age, sex, education level, comorbidity, tumour histology, tumour stage, surgical technique and neoadjuvant therapy.

Results: The cohort included 406 patients who survived at least 1 year after oesophageal cancer surgery. Of these, 273 (68%) had at least one complication in the first 30 postoperative days. Long-term HRQL was comparable between patients with or without complications, with or without medical and surgical complications and between different grades of complication severity.

Interpretation: This study suggests that the influence of complications within 30 days of oesophageal cancer surgery on HRQL is minor after 1 year.