LAsting Symptoms after Oesophageal Resectional Surgery (LASORS): multicentre validation cohort study
Paine, Heidi Chidambaram, Swathikan Johar, Asif Maynard, Nick Lagergren, Pernilla Griffiths, Ewen A Behrens, Paul Singh, Pritam Abbassi-Ghadi, Nima Preston, Shaun R
Paine, Heidi
Chidambaram, Swathikan
Johar, Asif
Maynard, Nick
Lagergren, Pernilla
Griffiths, Ewen A
Behrens, Paul
Singh, Pritam
Abbassi-Ghadi, Nima
Preston, Shaun R
Affiliation
University of Oxford; Oxford University Hospitals NHS Trust; Imperial College London; Imperial College Healthcare NHS Trust; Karolinska Institutet; University Hospitals Birmingham NHS Foundation Trust; University of Edinburgh; Royal Surrey County Hospital NHS Foundation Trust; Nottingham University Hospitals NHS Trust; Guy’s and St Thomas’ NHS Foundation Trust; University Hospital Southampton NHS Foundation Trust; Cambridge University Hospitals NHS Foundation Trust; University Hospitals of Derby & Burton NHS Foundation Trust; University College London Hospitals NHS Foundation Trust; Northern Care Alliance NHS Foundation Trust; University of Manchester; South Tees Hospitals NHS Foundation Trust
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Publication date
2025-02-21
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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.
Citation
Paine H, Chidambaram S, Johar A, Maynard N, Lagergren P, Griffiths EA, Behrens P, Singh P, Abbassi-Ghadi N, Preston SR, Vohra RS, Gossage J, Underwood T, Dai N, O'Neill JR, Awad S, Mohammadi B, Dawas K, Qureshi Y, Alkhaffaf B, Jones R, Hanna GB, Markar SR. LAsting Symptoms after Oesophageal Resectional Surgery (LASORS): multicentre validation cohort study. Br J Surg. 2025 Feb 1;112(2):znae319. doi: 10.1093/bjs/znae319.
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Article