Quality of Life Measures in Patients with Esophageal Cancer

Abstract:

Assessment of health-related quality of life in patients undergoing treatment for esophageal cancer is important as the disease is debilitating, treatments frequently toxic, and often life expectancy is poor. Measures need to be accurate, reliable, valid, and patient centred in order to be of clinical value. The aim of this chapter is to identify, summarise and evaluate patient reported outcome measures for this population. Literature reviews were undertaken and English language instruments that were multi-dimensional with reported psychometric properties were evaluated. Four questionnaires fulfilled these criteria (EORTC QLQ-OES18, FACT-E, EORTC QLQ-OG25, EQOL). Of these, one was developed from a questionnaire designed for patients with head and neck cancer (FACT-E) and one targeted patients undergoing potentially curative treatment alone (EQOL). Item reduction was generally performed with patient survey and expert opinion. The EORTC questionnaires formally tested scaling assumptions. Detailed validity testing was reported for all instruments, although the new EORTC module for oesophageal and gastric tumours lacks data supporting responsiveness. One questionnaire, the EORTC QLQ-OES18, fulfilled guidelines for instrument development and evaluation as outlined by the Medical Outcomes Trust and has been developed and most thoroughly tested in all appropriate patient groups. Rigorous instrument development is important for creating tools that can be used to inform clinical decision-making. More work is needed in evaluating current tools for esophageal cancer, with head to head comparisons and qualitative research to understand patients’ experiences of treatment and patient reported outcomes.