Patient perspectives on key symptoms and preferences for follow-up after upper gastro-intestinal cancer surgery

TY - JOUR

T1 - Patient perspectives on key symptoms and preferences for follow-up after upper gastro-intestinal cancer surgery

AU - On behalf of the RESTORE study group, Guy’s, St Thomas’ Oesophago-gastric research group

AU - Pucher, Philip H.

AU - Coombes, Annie

AU - Evans, Orla

AU - Taylor, Joanna

AU - Moore, Jonathan L.

AU - White, Annabelle

AU - Lagergren, Jesper

AU - Baker, Cara

AU - Kelly, Mark

AU - Gossage, James A.

AU - Dunn, Jason

AU - Zeki, Sebastian

AU - Byrne, Ben E.

AU - Andreyev, Jervoise

AU - Davies, Andrew R.

N1 - Publisher Copyright: © 2022, The Author(s).

PY - 2022/3/11

Y1 - 2022/3/11

N2 - Purpose: Long-lasting symptoms and reductions in quality of life are common after oesophago-gastric surgery. Post-operative follow-up has traditionally focussed on tumour recurrence and survival, but there is a growing need to also identify and treat functional sequelae to improve patients’ recovery. Methods: An electronic survey was circulated via a British national charity for patients undergoing oesophago-gastric surgery and their families. Patients were asked about post-operative symptoms they deemed important to their quality of life, as well as satisfaction and preferences for post-operative follow-up. Differences between satisfied and dissatisfied patients with reference to follow-up were assessed. Results: Among 362 respondents with a median follow-up of 58 months since surgery (range 3–412), 36 different symptoms were reported as being important to recovery and quality of life after surgery, with a median of 13 symptoms per patient. Most (84%) respondents indicated satisfaction with follow-up. Satisfied patients were more likely to have received longer follow-up (5-year or longer follow-up 60% among satisfied patients vs 27% among unsatisfied, p < 0.001). These were also less likely to have seen a dietitian as part of routine follow-up (37% vs 58%, p = 0.005). Conclusion: This patient survey highlights preferences regarding follow-up after oesophago-gastrectomy. Longer follow-up and dietician involvement improved patient satisfaction. Patients reported being concerned by a large number of gastrointestinal and non-gastrointestinal symptoms, highlighting the need for multidisciplinary input and a consensus on how to manage the poly-symptomatic patient.

AB - Purpose: Long-lasting symptoms and reductions in quality of life are common after oesophago-gastric surgery. Post-operative follow-up has traditionally focussed on tumour recurrence and survival, but there is a growing need to also identify and treat functional sequelae to improve patients’ recovery. Methods: An electronic survey was circulated via a British national charity for patients undergoing oesophago-gastric surgery and their families. Patients were asked about post-operative symptoms they deemed important to their quality of life, as well as satisfaction and preferences for post-operative follow-up. Differences between satisfied and dissatisfied patients with reference to follow-up were assessed. Results: Among 362 respondents with a median follow-up of 58 months since surgery (range 3–412), 36 different symptoms were reported as being important to recovery and quality of life after surgery, with a median of 13 symptoms per patient. Most (84%) respondents indicated satisfaction with follow-up. Satisfied patients were more likely to have received longer follow-up (5-year or longer follow-up 60% among satisfied patients vs 27% among unsatisfied, p < 0.001). These were also less likely to have seen a dietitian as part of routine follow-up (37% vs 58%, p = 0.005). Conclusion: This patient survey highlights preferences regarding follow-up after oesophago-gastrectomy. Longer follow-up and dietician involvement improved patient satisfaction. Patients reported being concerned by a large number of gastrointestinal and non-gastrointestinal symptoms, highlighting the need for multidisciplinary input and a consensus on how to manage the poly-symptomatic patient.

KW - Esophageal neoplasms

KW - Esophagectomy

KW - Gastrectomy

KW - Gastric neoplasms

KW - Survivorship

KW - Symptoms

UR - http://www.scopus.com/inward/record.url?scp=85126182939&partnerID=8YFLogxK

U2 - 10.1007/s00520-022-06922-w

DO - 10.1007/s00520-022-06922-w

M3 - Article

C2 - 35275293

AN - SCOPUS:85126182939

SN - 0941-4355

VL - 30

SP - 5269

EP - 5275

JO - Supportive Care in Cancer

JF - Supportive Care in Cancer

IS - 6

ER -