4.0 Article

Early experience with a nutrition and survivorship clinic in esophageal cancer

Journal

DISEASES OF THE ESOPHAGUS
Volume 34, Issue 2, Pages -

Publisher

OXFORD UNIV PRESS INC
DOI: 10.1093/dote/doaa061

Keywords

esophageal neoplasms; interdisciplinary communication; malnutrition; survivorship; weight loss

Funding

  1. Irish Cancer Society [CRS17MUR]
  2. Irish Research Council [IRCLA/2017/234]
  3. Irish Research Council (IRC) [IRCLA/2017/234] Funding Source: Irish Research Council (IRC)

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Improved cure rates in esophageal cancer care have led to increased focus on health-related quality of life (HRQL) in survivorship. A personalized multidisciplinary survivorship clinic was established to optimize recovery post-esophagectomy, with assessments including EORTC questionnaires, functional status review, anthropometry, and screening for micronutrient deficiencies. The study found significant weight loss, prevalent micronutrient deficiencies, and persistent dumping syndrome in esophageal cancer patients in the first year of survivorship.
Improved cure rates in esophageal cancer care have increased focus on health-related quality of life (HRQL) in survivorship. To optimize recovery after esophagectomy, particularly nutritional well-being, a personalized multidisciplinary survivorship clinic was established at this center. Assessments at 6 and 12 months postoperatively include validated European Organization for the Research and Treatment of Cancer (EORTC) symptom and health-related quality of life (HRQL) questionnaires, functional status review, anthropometry, and biochemical screening for micronutrient deficiencies. 75 patients, at a mean age of 63 years, 84% male, 85% with adenocarcinoma, and 73% receiving multimodal therapy were included. Mean preoperative body mass index (BMI) was 27.5 (4.3) kg m(-2). 6- and 12-month assessments were completed by 66 (88%) and 37 (93%) recurrence-free patients, respectively. Mean body weight loss at 6 months was 8.5 +/- 6.6% and at 12 months 8.8 +/- 7.3%. Of the 12-month cohort, micronutrient deficiency was present in 27 (79.4%) preoperatively and 29 (80.6%) after 1 year (P = 0.727), most commonly iron deficiency (preoperative: 16143.2%] and postoperative: 17 [45.9%] patients, P = 0.100). 26 (70.3%) of these patients also had clinically significant dumping syndrome persisting to 12 months after surgery. We describe a novel follow-up support structure for esophageal cancer patients in the first year of survivorship. This may serve as an exemplar model with parallel application across oncological care.

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