603. GASTROINTESTINAL SYMPTOMS, AND SYMPTOMS OF DELAYED GASTRIC CONDUIT EMPTYING, ONE YEAR AFTER DIAGNOSIS OF CANCER IN THE ESOPHAGUS

Abstract Background Improved survival after esophagectomy for esophageal cancer emphasises persistent symptoms related to the surgically altered anatomy. The Swedish national registry of esophageal and gastric cancer collects patient reported EORTC questionnaires OG25 and C30 12 months after diagnosis. These questionnaires adress gastrointestinal symptoms and specifically symptoms of delayed gastric conduit emptying (DGCE) according to diagnostic criteria defined in an international Delphi consensus. The aim of this study is to describe gastrointestinal symptoms, and symptoms of DGCE in a large cohort of patients, 12 months after diagnosis and esophagectomy for cancer with correlation to potential risk factors for DGCE. Methods Data for all cases that underwent esophagectomy with gastric conduit reconstruction during 2009-2018 was analysed. Baseline data was compared between responders and non-responders to the EORTC questionnaires to address responder bias. Frequency and severity of gastrointestinal symptoms was documented. An algorithm was created to identify cases reporting symptoms consistent with DGCE according to the symptom based part of the diagnostic criteria. Odds-ratios and 95% confidence intervals were calculated for univariate analysis for correlation to baseline data and risk factors and logistic regression used for multivariable analysis, using STATA v 16.1. Results Totally 484 (51,2%) responded the questionnaires. Responders were similar to non-pesponders regarding age, sex and ASA score. Early satiety was most commonly reported (44%), followed by concerns of low body weight, long time completing meals, enjoying meals and appetite. 147 patients (30.4%) reported symptoms compatible with DGCE. Patients with DGCE had a mean score of 3.79 (CI=3.57-4.0) for overall health compared to 5,13 (CI=5.0-5.26) non-DGCE patients. DGCE symptom patients had a mean score of 3.77 (CI=3.54-4.01) for overall quality of life compared to 5,22 (CI=5.08-5.36) for non-DGCE patients. Conclusion Almost one third of patients who had an esophagectomy with a gastric conduit reconstruction for esophageal cancer had symptoms compatible with DGCE after one year. Patients reporting symptoms of DGCE rated markedly lower for overall quality of life and overall health compared to patients without DGCE symptoms. This this study suggests that DGCE is a major quantitative and qualitative problem after esophagectomy.