Study Of Factors On Affecting Quality Of Life In Patients With Esophageal Or Cardiac Cancer

Objective: China has been well recognized as a high incidence area for esophageal carcinoma (EC) in the world. Recently, the morbidity of cardiac malignant tumor connecting with lower esophagus indicates a trend of increasing incidence. The advances in cancer diagnosis and treatment have allowed patients to have a longer life span than ever. However, there is evidence that oncologic patients may face with difficulties in their psychological adaptation and a worsening in quality of life (QOL). Because studies of QOL in EC patients are relatively few up to now, we retrospectively investigated the quality of life in patients with esophageal cancer(EC) or cardiac cancer(CC) after operation from 1996 to 2005 in the Fourth Hospital of Heibei Medical University using EORTC QLQ-C30 and OES-18. The European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and OES-18 are most widely used quality of life instruments for EC cancer patients. Factors influencing QOL of EC and CC were evaluated to explore effective measurements in order to improve QOL.Methods: Randomly selecting 372 cases of EC or CC from January 1996 to December 2005 in the Fourth Hospital of Hebei Medical University. The demographic and medical data were collected using the general information investigation form QLQ-C30 (3.0) and OES-18.All data were analyzed by SPSS13.0 software package. One-way ANOVO was used to evaluate the impact of different factors on QOL. Multiple linear regression was used to analyze the correlation of the 11 variables to QOL.Results:1 One-way ANOVA resultsThere were significant difference in physical functioning domains between male and female(P<0.05). Patients<50 years old had worse cognition functioning and were more susceptive to fatigue, while patients >60 years were more involved in ecomonic issues,dyspnoea,diarrhea.Patients at public expense showed a betteer performance in social functioning domains. Meanwhile, they were suffered less in economic difficulties and pain. Extrovert patients were better than introvert ones in physical,emotional,cognition,social,role functioning,general QOL. Introvert patients suffered more in fatigue,sleep,economic status,dyspnoea,diarrhea,appetite. Patients who know the disease themselves showed a better performance in role functioning and dyspnoea. It was indicated that patients in good mental status showed the best performance in emotional,dyspnoea,appetite than those in moderate or bad mental status,while patients in bad mental status suffered more in physical,pain,sleep,constipation and nausea and vomiting. There were significantly difference in cognition functioning,role functioning,general QOL among 1~2 years postoperation group, 2~5 years postoperation and≥5 years(P<0.05). Tumor location,clinical stage and infiltrating depth all showed different impact on diverse domains of QOL.As to OES-18 items, gender and age didn't showed significantly impact on diverse domains of QOL. Extrovert patients and those in good mental status all showed better performance in QOL. Moreover, time after operation,tumor location,clinical stage,infiltrating depth showed a certain effect on QOL(P<0.05).Conclusions:1 Gender and age influenced the different domains of QOL in EC or CC patients.2 Patients at public expense showed a betteer performance in social functioning domains.Meanwhile, they were suffered less in economic difficulties and pain.3 Extrovert patients were better than introvert ones in physical,emotional,cognition,social,role functioning,general QOL.Introvert patients suffered more in fatigue,sleep,economic status,dyspnoea,diarrhea,appetite.4 Patients who know the disease themselves showed a better performance in role functioning and dyspnoea.5 Patients in good mental status showed the best perfor- mance in emotional,dyspnoea,appetite than those in moderate or bad mental status,while patients in bad mental status suffered more in physical,pain,sleep,constipation,nausea and vomiting.6 There were significantly difference in cognition,role functioning,general QOL among 1~2 years postoperation group, 2~5 years postoperation and≥5 years(P<0.05).7 Multiple linear regression analysis revealed : gender,age,character,mental status,disease comprehend,tumor location and time after operation all showed different impact on diverse domains of QOL.