Heidi Paine, Swathikan Chidambaram, Asif Johar, Nick Maynard, Pernilla Lagergren, Ewen A Griffiths, Paul Behrens, Pritam Singh, Nima Abbassi-Ghadi, Shaun R Preston, Ravinder S Vohra, James Gossage, Tim Underwood, Nick Dai, J Robert O'Neill, Sherif Awad, Borzoueh Mohammadi, Khaled Dawas, Yassar Qureshi, Bilal Alkhaffaf, Rhys Jones, George B Hanna, Sheraz R Markar
{"title":"食管切除术后持续症状（LASORS）：多中心验证队列研究","authors":"Heidi Paine, Swathikan Chidambaram, Asif Johar, Nick Maynard, Pernilla Lagergren, Ewen A Griffiths, Paul Behrens, Pritam Singh, Nima Abbassi-Ghadi, Shaun R Preston, Ravinder S Vohra, James Gossage, Tim Underwood, Nick Dai, J Robert O'Neill, Sherif Awad, Borzoueh Mohammadi, Khaled Dawas, Yassar Qureshi, Bilal Alkhaffaf, Rhys Jones, George B Hanna, Sheraz R Markar","doi":"10.1093/bjs/znae319","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Long-term symptom burden and health-related quality-of-life outcomes after curative oesophageal cancer treatment are poorly understood. Existing tools are cumbersome and do not address the post-treatment population specifically. The aim of this study was to validate the six-symptom LASORS tool for identifying patients after curative oesophageal cancer treatment with poor health-related quality of life and to assess its clinical utility.</p><p><strong>Methods: </strong>Between 2015 and 2019, patients from 15 UK centres who underwent curative-intent oesophageal cancer treatment, and were disease-free at least 1 year after surgery, were invited to participate in the study and complete LASORS and European Organisation for Research and Treatment of Cancer QLQ-C30 and QLQ-OG25 questionnaires. Receiver operating characteristic curve analysis was used to examine the accuracy of the LASORS tool for identifying patients with poor health-related quality of life.</p><p><strong>Results: </strong>A total of 263 patients completed the questionnaire. Four of the six LASORS symptoms were associated with poor health-related quality of life: reduced energy (OR 2.13 (95% c.i. 1.45 to 3.13)); low mood (OR 1.86 (95% c.i. 1.20 to 2.88)); diarrhoea more than three times a day unrelated to eating (OR 1.48 (95% c.i. 1.06 to 2.07)); and bloating or cramping after eating (OR 1.35 (95% c.i. 1.03 to 1.77)). The LASORS tool showed good diagnostic accuracy with an area under the receiver operating characteristic curve of 0.858 for identifying patients with poor health-related quality of life.</p><p><strong>Conclusion: </strong>The six-symptom LASORS tool generated a reliable model for identification of patients with poor health-related quality of life after curative treatment for oesophageal cancer. This is the first tool of its kind to be prospectively validated in the post-esophagectomy population. 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Four of the six LASORS symptoms were associated with poor health-related quality of life: reduced energy (OR 2.13 (95% c.i. 1.45 to 3.13)); low mood (OR 1.86 (95% c.i. 1.20 to 2.88)); diarrhoea more than three times a day unrelated to eating (OR 1.48 (95% c.i. 1.06 to 2.07)); and bloating or cramping after eating (OR 1.35 (95% c.i. 1.03 to 1.77)). The LASORS tool showed good diagnostic accuracy with an area under the receiver operating characteristic curve of 0.858 for identifying patients with poor health-related quality of life.</p><p><strong>Conclusion: </strong>The six-symptom LASORS tool generated a reliable model for identification of patients with poor health-related quality of life after curative treatment for oesophageal cancer. This is the first tool of its kind to be prospectively validated in the post-esophagectomy population. 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引用次数: 0
摘要
背景：食管癌根治性治疗后的长期症状负担和健康相关的生活质量结果尚不清楚。现有的工具很麻烦，不能专门针对治疗后人群。本研究的目的是验证六症状LASORS工具用于识别食管癌治疗后健康相关生活质量较差的患者，并评估其临床实用性。方法：在2015年至2019年期间，来自英国15个中心的接受治愈意图食管癌治疗且术后至少1年无疾病的患者被邀请参加研究，并完成LASORS和欧洲癌症研究与治疗组织QLQ-C30和QLQ-OG25问卷。使用受试者工作特征曲线分析来检验LASORS工具识别健康相关生活质量较差患者的准确性。结果：共263例患者完成问卷调查。6种LASORS症状中有4种与较差的健康相关生活质量相关：精力减少（OR 2.13 (95% ci: 1.45 - 3.13)）；情绪低落（OR 1.86 (95% ci 1.20 ~ 2.88)）；每天腹泻超过三次，与进食无关（OR 1.48 (95% ci 1.06至2.07)）；进食后腹胀或痉挛（or 1.35 (95% ci 1.03至1.77)）。LASORS工具对健康相关生活质量较差患者的诊断准确率较高，受试者工作特征曲线下面积为0.858。结论：六症状LASORS工具为鉴别食管癌根治性治疗后健康相关生活质量差的患者提供了可靠的模型。这是同类中第一个在食管切除术后人群中进行前瞻性验证的工具。临床效用在于识别与健康有关的生活质量差的患者，易于使用该工具，并规划生存服务。
LAsting Symptoms after Oesophageal Resectional Surgery (LASORS): multicentre validation cohort study.
Background: Long-term symptom burden and health-related quality-of-life outcomes after curative oesophageal cancer treatment are poorly understood. Existing tools are cumbersome and do not address the post-treatment population specifically. The aim of this study was to validate the six-symptom LASORS tool for identifying patients after curative oesophageal cancer treatment with poor health-related quality of life and to assess its clinical utility.
Methods: Between 2015 and 2019, patients from 15 UK centres who underwent curative-intent oesophageal cancer treatment, and were disease-free at least 1 year after surgery, were invited to participate in the study and complete LASORS and European Organisation for Research and Treatment of Cancer QLQ-C30 and QLQ-OG25 questionnaires. Receiver operating characteristic curve analysis was used to examine the accuracy of the LASORS tool for identifying patients with poor health-related quality of life.
Results: A total of 263 patients completed the questionnaire. Four of the six LASORS symptoms were associated with poor health-related quality of life: reduced energy (OR 2.13 (95% c.i. 1.45 to 3.13)); low mood (OR 1.86 (95% c.i. 1.20 to 2.88)); diarrhoea more than three times a day unrelated to eating (OR 1.48 (95% c.i. 1.06 to 2.07)); and bloating or cramping after eating (OR 1.35 (95% c.i. 1.03 to 1.77)). The LASORS tool showed good diagnostic accuracy with an area under the receiver operating characteristic curve of 0.858 for identifying patients with poor health-related quality of life.
Conclusion: The six-symptom LASORS tool generated a reliable model for identification of patients with poor health-related quality of life after curative treatment for oesophageal cancer. This is the first tool of its kind to be prospectively validated in the post-esophagectomy population. Clinical utility lies in identification of patients at risk of poor health-related quality of life, ease of use of the tool, and in planning survivorship services.
期刊介绍：
The British Journal of Surgery (BJS), incorporating the European Journal of Surgery, stands as Europe's leading peer-reviewed surgical journal. It serves as an invaluable platform for presenting high-quality clinical and laboratory-based research across a wide range of surgical topics. In addition to providing a comprehensive coverage of traditional surgical practices, BJS also showcases emerging areas in the field, such as minimally invasive therapy and interventional radiology.
While the journal appeals to general surgeons, it also holds relevance for specialty surgeons and professionals working in closely related fields. By presenting cutting-edge research and advancements, BJS aims to revolutionize the way surgical knowledge is shared and contribute to the ongoing progress of the surgical community.
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