Health-related quality of life and survival among 10-year survivors of esophageal cancer surgery: gastric tube reconstruction versus whole stomach reconstruction

Esophageal cancer is the eighth most common type of cancer and the sixth most common cause of cancer-related mortality (1). Tumor recurrences typically occur within the first year after surgery, and are usually followed by rapid death (2). Survival at 1 year, 3 years and 5 years after surgery was 46.5%, 24.1%, and 19.7% respectively in 1987–1991. In 1997–2000, the survival at 1, 3 and 5 years improved to 61.7%, 39.9%, and 30.7%, respectively (3). Despite improved survival during the past decades, the 5-year survival is still relatively low in patients undergoing curatively intended surgery. The 10-year survival is barely reported and little is known about the factors influencing the long-term (10-year) survival. Although the long-term survival remains low, esophagectomy is still the key curatively intended treatment for patients with esophageal cancer. Esophagectomy is a highly invasive procedure with a 50% risk of severe postoperative complication within 30 days of surgery (4). For this disease with comparatively poor prognosis and high incidence of postoperative complications, survival alone cannot be able to adequately describe outcome. Nowadays, health-related quality of life (HRQL) has been paid more and more attention. Esophagectomy greatly impacts on emotional, physical and social health. It has highly negative and long-lasting consequences for the patient’s HRQL. Some studies have reported a recovery of HRQL to preoperative levels at 3 years after surgery (5); others reported that certain patients could even have substantially worse HRQL within 5 years of surgery (6). Factors influencing HRQL after surgery is still in debate. Our previous research indicated that patients with gastric tube reconstruction may present a better HRQL within 5 years of surgery, but it is unclear whether this recovery persists over time