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Upper Gastrointestinal (lips to ileocecal valve, including esophagus and stomach)

E460: Long-Term Quality of Life and Survivorship Priorities in Esophagogastric Cancer Patients

Introduction: Esophagogastric cancer (EGC) significantly impacts patients' quality of life (QOL). Recognizing patients' priorities can guide patient-centric care. This study examines the long-term QOL and priorities of EGC survivors.

Methods: EGC patients were surveyed through online support groups. Questions addressed how patients ranked priorities such as longevity, costs, experience, and functional and emotional well-being. Using the Short Form-12 questionnaire, health-related QOL in both physical (P-QOL) and mental (M-QOL) domains were compared to that of the general population. Factors such as the presence of metastatic disease, surgical intervention, and survival duration (short-term vs long-term) were evaluated in relation to patients' QOL and priorities.

Results: Among 100 respondents (age 61±11 years, 54% male, 90% Caucasian), average time from cancer diagnosis was 44.8 months, with a maximum survivorship of 48.3 years. 81% had esophageal cancer and 19% gastric cancer; 80% were diagnosed with adenocarcinoma. Of all patients, 66% underwent surgical management and 26% had metastatic disease. With moderate agreement among respondents, patients ranked longevity the most important priority, followed by functional independence, emotional well-being, treatment experience, and costs (W=0.38, p< 0.001). Some survivors ranked treatment experience (4%) or costs (6%) as their most important priority in care. Priority rank-order was similar among patients with metastatic disease and those who underwent surgery. Overall, the cohort's P-QOL (40±10) and M-QOL (42±15) were lower than that of the general population (50±10); both p< 0.001. Compared to patients with localized disease, metastatic disease survivors showed no difference in P-QOL (39±10 vs 41±10, p=0.559) or M-QOL (40±16 vs 44±15, p=0.320). Surgical patients, however, had a superior M-QOL (45±15 vs 37±15, p=0.010). While P-QOL remained consistent over time (40±10 at < 1 year vs 40±11 at >5 years, p=0.914), M-QOL improved with extended survivorship (37±14 at < 1 year vs 47±16 at >5 years, p=0.008), see figure.

Conclusions: EGC survivors experience long-term health impairments yet place paramount importance on longevity. Despite enduring health-related physical impairments, there is improvement in their mental well-being throughout survivorship. Still, some survivors prioritize costs and treatment experience above all else. These findings underscore the importance of tailoring treatments to ensure alignment with patient-driven priorities.

Learning Objectives:

  • Demonstrate that esophagogastric cancer survivors experience long-term health impairments throughout survivorship but prioritize longevity. Although, some survivors still consider costs and treatment experience as most important.
  • Delineate that despite facing physical impairments, there is discernable improvement in their mental well-being as survivorship increases.
  • Understand that treatment protocols for patients with esophagogastric cancer should ensure alignment with patient priorities.