Systematic Review and Meta-Analysis of Patient Experiences of Oesophageal Cancer Survivorship After Oesophagectomy.

Jonathan Sivakumar, Thang Dao, Feras Alnimri, David S Liu, Qianyu Chen, Rebekah Laidsaar-Powell, Michael W Hii, Cuong Phu Duong

Journal: Psycho-oncology 2026;35(5):e70482

PMID: 42112779

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Abstract

BACKGROUND

Despite improving survival rates, the complexity of post-operative survivorship for oesophageal cancer patients remains poorly understood. This mixed-methods review explores quantitative health-related quality-of-life (HRQoL) outcomes and qualitative survivor experiences to provide a comprehensive, person-centred perspective.

METHODS

A convergent synthesis framework was employed to examine patient perspectives on survivorship following oesophageal cancer resection. A systematic search of the literature was undertaken across four databases to identify studies reporting EORTC QLQ-C30 and QLQ-OES18 outcomes and qualitative research exploring post-operative experiences. Quantitative studies underwent random-effects meta-analysis to examine HRQoL trajectories from baseline to 5 years post-operatively. Qualitative studies underwent thematic synthesis following Thomas and Harden's established three-stage framework.

RESULTS

Fifty-seven studies were included, consisting of 40 quantitative and 17 qualitative studies. HRQoL followed a triphasic pattern with a marked deterioration at 6 months, partial recovery by 12-36 months, followed by a plateau with persistent symptoms at 5 years. Reflux, eating restriction and fatigue were the most prevalent symptoms following oesophagectomy. Thematic synthesis identified five domains of oesophageal cancer survivorship; digestive disruption, physical impairment, psychosocial impact, navigating healthcare and support systems, and striving for normalcy. Qualitative accounts revealed challenges under-represented in quantitative measures, including an altered relationship with food, fear of recurrence, as well as identity loss.

CONCLUSIONS

Post-oesophagectomy survivorship is a sustained process of adaptation, not a return to baseline health. Current oncology-centred care models overlook chronic, multidimensional needs of patients. Integrated survivorship pathways combining nutritional support, rehabilitation, and psychosocial support are essential to restore agency and improve long-term wellbeing.

Address: Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia.; Department of Surgery, The University of Melbourne, Melbourne, Australia.; Department of Gastroenterology, St Vincent's Hospital Melbourne, Fitzroy, Australia.; Department of Medicine, The University of Melbourne, Melbourne, Australia.; Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia.; Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia.; Upper Gastrointestinal Surgery Unit, Austin Hospital, Heidelberg, Australia.; Department of Surgery, Victorian Interventional Research and Trials Unit, The University of Melbourne, Heidelberg, Australia.; Department of Upper Gastrointestinal Surgery, St Vincent's Hospital Melbourne, Fitzroy, Australia.; Psycho-Oncology Cooperative Research Group (PoCoG), School of Psychology, The University of Sydney, Sydney, Australia.; Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia.; Department of Upper Gastrointestinal Surgery, St Vincent's Hospital Melbourne, Fitzroy, Australia.

DOI: 10.1002/pon.70482

MeSH Terms: Humans, Esophageal Neoplasms, Esophagectomy, Quality of Life, Cancer Survivors, Survivorship, Qualitative Research