Journal
SUPPORTIVE CARE IN CANCER
Volume 21, Issue 2, Pages 511-519Publisher
SPRINGER
DOI: 10.1007/s00520-012-1537-1
Keywords
Esophageal neoplasms; Barrett esophagus; Quality of life; Comparative study; Survival; Survivorship
Funding
- Public Health Service [CA 25224, CA 37404]
- American Digestive Health Foundation
- American College of Gastroenterology
- Glaxo Wellcome Inc. Institute for Digestive Health
- Miles and Shirley Fiterman Center for Digestive Diseases at Mayo Clinic, Rochester, MN
- ACOSOG [CA149950]
- National Institutes of Health [NIDDK 02956]
- Robert Wood Johnson Foundation Harold Amos Medical Faculty Development Program
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A prospective cohort study was conducted to analyze whether self-reported fatigue predicts overall survival in patients with esophageal cancer. Patients enrolled in the Mayo Clinic Esophageal Adenocarcinoma and Barrett's Esophagus Registry between September 2001 and January 2009 who completed a baseline quality of life instrument were eligible for evaluation. The fatigue component was scored on a 0-10 scale, with 0 as extreme fatigue. Patients were categorized as having a decreased energy level if they reported a score of a parts per thousand currency sign5. Fatigue scores a parts per thousand yen6 reflect normal levels of energy. Data from a total of 659 enrolled patients were analyzed. A total of 392 (59 %) and 267 (41 %) patients reported decreased and normal energy, respectively. Univariate analysis indicates patients with normal energy had improved 5-year survival compared to patients with decreased energy (37 vs 28 %, hazard ratio (HR) 0.74, p = 0.006). Among the patients with locally advanced disease, the same relationship was seen (28 vs 17 %, HR = 0.67, p = 0.003); this remained significant on multivariate analysis (HR = 0.71, p = 0.015). A decreased energy level is associated with poor survival in patients with esophageal cancer. Thus, patients with high levels of fatigue should be referred for psychological support and be considered for therapy aimed at amelioration of fatigue symptoms.
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