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LAsting Symptoms after Oesophageal Resectional Surgery (LASORS): multicentre validation cohort study
Paine, H. Chidambaram, S. Johar, A. Maynard, N. Lagergren, P. Griffiths, E. A. Behrens, P. Singh, P. Abbassi-Ghadi, N. Preston, S. R.
Paine, H.
Chidambaram, S.
Johar, A.
Maynard, N.
Lagergren, P.
Griffiths, E. A.
Behrens, P.
Singh, P.
Abbassi-Ghadi, N.
Preston, S. R.
Abstract
BACKGROUND: Long-term symptom burden and health-related quality-of-life outcomes after curative oesophageal cancer treatment are poorly understood. Existing tools are cumbersome and do not address the post-treatment population specifically. The aim of this study was to validate the six-symptom LASORS tool for identifying patients after curative oesophageal cancer treatment with poor health-related quality of life and to assess its clinical utility. METHODS: Between 2015 and 2019, patients from 15 UK centres who underwent curative-intent oesophageal cancer treatment, and were disease-free at least 1 year after surgery, were invited to participate in the study and complete LASORS and European Organisation for Research and Treatment of Cancer QLQ-C30 and QLQ-OG25 questionnaires. Receiver operating characteristic curve analysis was used to examine the accuracy of the LASORS tool for identifying patients with poor health-related quality of life. RESULTS: A total of 263 patients completed the questionnaire. Four of the six LASORS symptoms were associated with poor health-related quality of life: reduced energy (OR 2.13 (95% c.i. 1.45 to 3.13)); low mood (OR 1.86 (95% c.i. 1.20 to 2.88)); diarrhoea more than three times a day unrelated to eating (OR 1.48 (95% c.i. 1.06 to 2.07)); and bloating or cramping after eating (OR 1.35 (95% c.i. 1.03 to 1.77)). The LASORS tool showed good diagnostic accuracy with an area under the receiver operating characteristic curve of 0.858 for identifying patients with poor health-related quality of life. CONCLUSION: The six-symptom LASORS tool generated a reliable model for identification of patients with poor health-related quality of life after curative treatment for oesophageal cancer. This is the first tool of its kind to be prospectively validated in the post-esophagectomy population. Clinical utility lies in identification of patients at risk of poor health-related quality of life, ease of use of the tool, and in planning survivorship services.
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Date
2025
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Article
Citation
Paine H, Chidambaram S, Johar A, Maynard N, Lagergren P, Griffiths EA, et al. LAsting Symptoms after Oesophageal Resectional Surgery (LASORS): multicentre validation cohort study. The British journal of surgery. 2025 Feb 1;112(2). PubMed PMID: 39982378. Pubmed Central PMCID: PMC11843645. Epub 2025/02/21. eng.