Health-related quality of life of esophageal cancer patients in daily life after treatment: A multicenter cross-sectional study in China

Background: The improvement of diagnostic and therapeutic techniques has prolonged the survival time of patients with esophageal cancer. Little is known, however, about their health-related quality of life (HRQoL) in daily life after treatment. Methods: Esophageal cancer patients who had been discharged from hospitals more than one year and healthy controls identified by screening were recruited from seven study centers covering eastern, central, and western regions of China. Patients were categorized into severe dysplasia/carcinoma in situ and stages I, II, III, and IV cancer, respectively. The EQ-5D was employed to assess HRQoL. Multivariate regression analyses were conducted. Results: A total of 1456 patients and 2179 controls were recruited. After adjusting for potential confounding factors, the likelihood of reporting problems in the five dimensions of patients was 3.8 to 23.1 times higher than controls, whilst the mean EQ-5D utility score was 0.311 (95% CI, 0.276-0.346) lower than controls. The mean utility scores of each patient subgroup were 0.158, 0.289, 0.303, 0.296, and 0.505 (95% CIs: 0.108-0.208, 0.243-0.336, 0.261-0.346, 0.244-0.347, and 0.437-0.573) lower than controls, respectively. Patients had the greatest impairment in the self-care dimension compared with controls, followed by the usual activities dimension. Therapeutic regimen, duration of illness, other chronic disease status, age, and marital status also had significant impact on different aspects of HRQoL in patients. Conclusions: Esophageal cancer significantly impaired patients' HRQoL in daily life after treatment. Advanced cancer stages were associated with larger decrements on health state utility. Utility scores reported here can facilitate further cost-utility analyses.