食管癌根治性治疗后是否存在不同的长期疾病特异性 HRQL 轨迹以及与此类轨迹相关的因素尚不清楚。 这项基于人群的纵向队列研究包括 425 名在瑞典接受根治性治疗（包括食管切除术）的食管癌患者2001-2005年随访至2020年，即15年随访。结果是 10 种疾病特异性 HRQL 症状，通过经过充分验证的 EORTC QLQ-OES18 问卷在 6 个月时测量（n = 402 名患者），以及 3 种 (n = 178)、5 种 (n = 141)、10 种 (n = 92），以及治疗后15年（n = 52）。通过生长混合模型检查 HRQL 症状的不同轨迹。加权逻辑回归模型为与 HRQL 轨迹相关的九个因素提供了 95% 置信区间 (95% CI) 的比值比 (OR)：年龄、性别、教育、代理基线 HRQL、合并症、肿瘤组织学、化疗（放射）治疗、病理肿瘤分期和术后并发症。针对 10 种疾病特异性症状中的每一种都确定了不同的 HRQL 轨迹。症状较多的 HRQL 轨迹往往会随着时间的推移而持续或缓解，而症状较少的轨迹则更加稳定。进食困难有三种轨迹：症状持续较少、症状持续中等和症状持续较多。对于腺癌组织学，持续进食困难轨迹的 OR 降低（OR = 0.44，95% CI 0.21-0.95），而对于病理肿瘤分期 III-IV 期则增加（OR = 2.19，95% CI 0.99-4.82），术后 30 天并发症（OR = 2.54，95% CI 1.26-5.12）。食管癌治疗后，确定了长期持续或恶化的疾病特异性 HRQL 症状的独特轨迹。肿瘤组织学、肿瘤分期和术后并发症可能有助于检测高危患者的不良轨迹。© 2024 作者。约翰·威利出版的癌症医学

The presence of distinct long-term disease-specific HRQL trajectories after curative treatment for esophageal cancer and factors associated with such trajectories are unclear.This population-based and longitudinal cohort study included 425 esophageal cancer patients who underwent curative treatment, including esophagectomy, in Sweden in 2001-2005 and were followed up until 2020, that is, 15-year follow-up. The outcomes were 10 disease-specific HRQL symptoms, measured by the well-validated EORTC QLQ-OES18 questionnaire at 6 months (n = 402 patients), and 3 (n = 178), 5 (n = 141), 10 (n = 92), and 15 years (n = 52) after treatment. HRQL symptoms were examined for distinct trajectories by growth mixture models. Weighted logistic regression models provided odds ratios (OR) with 95% confidence intervals (95% CI) for nine factors in relation to HRQL trajectories: age, sex, education, proxy baseline HRQL, comorbidity, tumor histology, chemo(radio)therapy, pathological tumor stage, and postoperative complications.Distinct HRQL trajectories were identified for each of the 10 disease-specific symptoms. HRQL trajectories with more symptoms tended to persist or alleviate over time, while trajectories with fewer symptoms were more stable. Eating difficulty had three trajectories: persistently less, persistently moderate, and persistently more symptoms. The OR of having a persistently more eating difficulty trajectory was decreased for adenocarcinoma histology (OR = 0.44, 95% CI 0.21-0.95), and increased for pathological tumor stage III-IV (OR = 2.19, 95% CI 0.99-4.82) and 30-day postoperative complications (OR = 2.54, 95% CI 1.26-5.12).Distinct trajectories with long-term persistent or deteriorating disease-specific HRQL symptoms were identified after esophageal cancer treatment. Tumor histology, tumor stage, and postoperative complications may facilitate detection of high-risk patients for unwanted trajectories.© 2024 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd.