Quality of Life for Patients with Esophageal/Gastric Cardia Precursor Lesions or Cancer: A One-year Prospective Study

Background: The current study examined health-related quality of life (QoL) for patients with esophageal/gastric cardia precursor lesions or cancer before and after treatment to facilitate improved prevention andtreatment. Materials and
Methods: Patients with different stages of esophageal/gastric cardia lesions completedtwo QoL questionnaires, EORTC QLQ-C30 and supplemental QLQ-OES 18, before primary treatment, and at 1,6 and 12 months after treatment.
Results: Fifty-nine patients with precursor lesions, 57 with early stage cancer,and 43 with advanced cancer responded to our survey. Patients with precursor lesions or early stage cancerreported better QoL overall than those with advanced cancer before treatment (p<0.01). Global QoL scores beforetreatment and at 1 month after treatment were 71±9 versus 69±9 (p>0.01), 71±8 versus 61±11 (p<0.01), 67 ± 11versus 62 ± 9 (p<0.01) for three stages of lesions. At 6 months after treatment, some QoL measures recoveredgradually in precursor lesion and early cancer patients, while some continuously deteriorated in advancedcancer patients. At 12 months, all QoL scores were comparable to baseline for patients with precursor lesions(p>0.01), while global QoL, social, pain, and insomnia scores for early stage and advanced cancer were inferior tocorresponding baseline levels (difference between means>5, p<0.01). At this time point, compared with patientswith early stage cancer, those with advanced cancer showed worse QoL with all function and most symptommeasures (p<0.01).
Conclusions: Patients with precursor lesions or early stage esophageal/gastric cardia cancershow better QoL than those with advanced cancer. This indicates that screening, early diagnosis and treatmentmay improve the QoL for esophageal/gastric cardia cancer patients. Target intervention and counseling shouldbe given by health care providers during treatment and follow-up to facilitate QoL improvement.