Follow-up study on symptom distress in esophageal cancer patients undergoing repeated dilation

doi:10.12998/wjcc.v8.i16.3503

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World Journal of Clinical Cases

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World J Clin Cases. Aug 26, 2020; 8(16): 3503-3514
Published online Aug 26, 2020. doi: 10.12998/wjcc.v8.i16.3503

Follow-up study on symptom distress in esophageal cancer patients undergoing repeated dilation

Li Liu, Qian-Wen Liu, Xiao-Dan Wu, Shu-Yue Liu, Hui-Jiao Cao, Yu-Tong Hong, Hui-Ying Qin

Li Liu, Yu-Tong Hong, Thoracic Department, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China

Li Liu, Qian-Wen Liu, Xiao-Dan Wu, Shu-Yue Liu, Hui-Jiao Cao, Yu-Tong Hong, Hui-Ying Qin, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, Guangdong Province, China

Qian-Wen Liu, Department of Endoscopy, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China

Xiao-Dan Wu, Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China

Shu-Yue Liu, Hepatopancreatobiliary Surgery Department, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China

Hui-Jiao Cao, Traditional Chinese Medicine Department, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China

Hui-Ying Qin, Department of Nursing, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China

Author contributions: Liu L and Liu QW contributed equally to this work; Liu L, Liu QW, and Qin HY contributed to the conception and design of the study; Wu XD and Hong YT contributed to the administrative support; Liu QW, Liu L, and Qin HY contributed to the provision of study materials or patients; Liu SY, Hong YT, and Cao HJ contributed to the collection and assembly of data; Liu L and Wu XD contributed to the data analysis and interpretation; all authors contributed to the writing and final approval of the manuscript.

Supported by Natural Science Foundation of Guangdong Province of China, No. 2017A030313449; and Science and Technology Planning Project of Guangdong Province of China, No. A2018057.

Institutional review board statement: The Institutional Review Board of Sun Yat-sen University Cancer Center provided approval for this study (GYX2018-010).

Informed consent statement: All study participant provided informed written consent.

Conflict-of-interest statement: The authors declare no conflicts of interest.

Data sharing statement: No additional data are available.

STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.

Corresponding author: Hui-Ying Qin, MNurs, Chief Nurse, Head, Department of Nursing, Sun Yat-sen University Cancer Center, No. 651 Dongfeng East Road, Guangzhou 510060, Guangdong Province, China. qinhy@sysucc.org.cn

Received: May 8, 2020
Peer-review started: May 8, 2020
First decision: June 2, 2020
Revised: June 3, 2020
Accepted: July 14, 2020
Article in press: July 14, 2020
Published online: August 26, 2020
Processing time: 106 Days and 22.7 Hours

Abstract

BACKGROUND

Repeated endoscopic probe dilatation is the most preferred treatment for esophageal stenosis which may cause high levels of symptom distress in the patient's home rehabilitation stage.

AIM

To explore the changes in the symptom distress level and its correlation with the dilation effect in patients with esophageal carcinoma undergoing repeated dilations for lumen stenosis.

METHODS

The difference (R2-R1) between the diameter of the esophageal stenosis opening (R1) of the patients before dilation (R1) and after dilation (R2) was calculated to describe the extent and expansion of the esophageal stenosis before and after dilation. The M.D. Anderson Symptom Inventory was used to describe the symptom distress level of patients with dilation intermittence during their stay at home and to explore the correlation between the dilation effect and symptom distress level.

RESULTS

The diameter of the esophagus (R1) increased before each dilation in patients undergoing esophageal dilation (P < 0.05). The diameter (R2) increased after dilation (P < 0.05); the dilation effect (R2-R1) decreased with the number of dilations (P < 0.05). The total symptom distress score significantly increased with the number of dilations (P < 0.05). The symptom distress scores of the patients were negatively correlated (P < 0.05) with the previous dilation effect (R2-R1) and the esophageal diameter (R2) after the previous dilation. After the 1^st to 4^th dilations, the patient's symptom distress score was negatively correlated with the esophageal diameter (R12) before the next dilation, while there was no significant correlation (P > 0.05) with the other dilations.

CONCLUSION

In patients who have undergone repeated dilations, better effect stands for lower symptom distress level and the increase in symptom distress has a prompt effect on the severity of the next occurrence of restenosis.

Keywords: Esophageal carcinoma; Dilation of esophageal stenosis; Symptom distress; Dilation effect; Lumen stenosis; Repeated dilation

Core tip: Esophageal carcinoma ranks 6^th in terms of the associated mortality rate and the incidence of complications after standardized comprehensive treatment of esophageal carcinoma is between 12.3% and 38%. Repeated endoscopic probe dilatation is the most preferred treatment for esophageal stenosis, which may cause high levels of symptom distress in the patient's home rehabilitation stage. This study explored the changes in the symptom distress level and its correlation with the dilation effect in patients with esophageal carcinoma undergoing repeated dilations for lumen stenosis. Based on these data, we can find the changes in the symptom distress level and its correlation with the dilation effect, which can contribute to patients’ symptoms management.