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SEATTLE -- Only about 40% of patients who undergo minimally invasive esophagectomy for esophageal cancer had reached full occupational recovery 1 year postoperatively, a retrospective study found.
Among a group of 86 patients, 40.8% were fully active occupationally at 12 months and 28.2% were partially active, but about 30% had still not returned to work, according to Melissa Geeraerts, MD, of ZGT Almelo in Belgium.
Then at 18 months, 43.1% were fully employed but only 19% had partially returned to work and 37.9% were non-active occupationally, she reported at the here.
Esophageal cancer is the eighth most common cancer in the world and ranks sixth in cancer-related mortality. The most popular areas of research for cancer have been morbidity, mortality, and complications, but in the past decade there has been growing attention to work-related rehabilitation in cancer patients, especially in patients with breast and colorectal cancer, the largest patient groups.
"Returning to work may enhance patients' quality of life and is often seen as a symbol of recovery, but little is known about work rehabilitation in esophageal cancer," she said.
Therefore, to investigate work rehabilitation after minimally invasive esophagectomy and whether patients regain their full job potential, she and her colleagues retrieved data from three referral hospitals in the Netherlands and provided questionnaires to participants. These questionnaires asked about preoperative employment status, whether they were full or part time workers, if an employee or self-employed, and whether they had blue-collar or white-collar jobs.
Patients' mean age was 57; 70% were men and half were blue-collar workers. Median follow-up was 18 months, and mean time spent in the hospital was 12 days. More than 70% had adenocarcinoma, and more than 60% had received neoadjuvant chemo-radiotherapy.
At 3 months postoperatively, 70% were not working and only 9% were working to their full ability, Geeraerts reported.
The only factor that significantly predicted full return to work was being self-employed, with an odds ratio of 2.45 (95% CI 1.32 to 4.56, P=0.005). A trend was seen toward slower work rehabilitation among patients who had grade III or IV complications (OR 0.53, 95% CI 0.23 to 1.22, P=0.136) compared with patients with grades I or II complications (OR 1.16, 95% CI 0.60 to 2.25, P=0.664).
A total of 55.8% patients reported complaints that prevented them from going back to work, with the most common being mental/physical fatigue.
"In conclusion, only about 70% of patients were back at work, either fully or partially, a year after minimally invasive esophagectomy. Therefore, it is important to prepare and inform our patients about the impact of this procedure on their professional capacities," she stated.