Gastrointestinal symptom profiles after resection of esophageal or gastric cancer.
12 affiliations
- 1Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Rijnkade 5, 3511 LC, Utrecht, The Netherlands. [email protected].
- 2Department of Medical Oncology, Amsterdam UMC Location University of Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. [email protected].
- 3Cancer Center Amsterdam, Cancer Treatment and Quality of Life, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. [email protected].
- 4Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Rijnkade 5, 3511 LC, Utrecht, The Netherlands.
- 5Department of Medical Informatics, Amsterdam UMC, Amsterdam, The Netherlands.
- 6Department of Surgery, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands.
- 7Department of Medical Oncology, Amsterdam UMC Location University of Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
- 8Cancer Center Amsterdam, Cancer Treatment and Quality of Life, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
- 9Department of Surgery, Amsterdam UMC Location University of Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
- 10Department of Surgery, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands.
- 11Radiotherapiegroep, Nico Bolkesteinlaan 85, 7416 SE, Deventer, The Netherlands.
- 12Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
Abstract
Purpose
Persistent gastrointestinal symptoms are common after esophagectomy or gastrectomy, which frequently co-occur and significantly decrease quality of life. This study aimed to identify gastrointestinal symptom profiles over the first-year post-surgery and to explore changes over time.Methods
Patients diagnosed between 2013 and 2024 who underwent esophagectomy or gastrectomy for nonmetastatic esophageal or gastric cancer were selected. Longitudinal self-reported gastrointestinal symptom data were linked to patient and tumor characteristics. K-means clustering based on symptom severity scores was performed at baseline and at every three months up to 12 months postoperatively. Generalized Linear Mixed Models assessed associations between patient characteristics and symptom profiles.Results
Among 1462 patients who underwent esophagectomy and 434 who underwent gastrectomy, three symptom severity profiles, mild, moderate, and severe, were identified for each period. These profiles reflected increasing symptom severity rather than distinct symptom patterns. The mild symptom profile was the most common (esophagectomy: 42.5 ~ 60.5%; gastrectomy: 53.9 ~ 73.5% across time periods). Most patients remained in the same profile over time. Amongst others, female sex (esophagectomy: OR = 1.67; 95% CI:1.30-2.14, gastrectomy: OR = 1.54; 95% CI:1.07-2.23) and receiving neoadjuvant chemotherapy (esophagectomy: OR = 1.91; 95% CI:1.22-2.99, gastrectomy: OR = 2.39; 95% CI:1.55-3.67) were associated with a higher likelihood of moderate/severe symptom profile.Conclusions
Three stable gastrointestinal symptom severity profiles were identified during the first postoperative year, supporting risk-stratified monitoring after upper gastrointestinal cancer surgery. Early identification of patients at risk for persistent moderate-to-severe gastrointestinal symptoms may facilitate timely supportive care and improve survivorship outcomes.
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BibTeX
@article{lee2026gastrointestinal,
title = {{Gastrointestinal symptom profiles after resection of esophageal or gastric cancer.}},
author = {Yipei Lee and Dimitris Katsimpokis and Felice N van Erning and Grard A P Nieuwenhuijzen and Hanneke W M van Laarhoven and Suzanne S Gisbertz and Bastiaan R Klarenbeek and Paul M Jeene and Roos E Pouw and Loes Noteboom and Rob H A Verhoeven and Pauline A J Vissers},
journal = {Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer},
year = {2026},
month = oct,
doi = {10.1007/s00520-026-11293-7},
url = {https://europepmc.org/article/MED/42842001},
note = {CC BY},
}
RIS
TY - JOUR
TI - Gastrointestinal symptom profiles after resection of esophageal or gastric cancer.
AU - Yipei Lee
AU - Dimitris Katsimpokis
AU - Felice N van Erning
AU - Grard A P Nieuwenhuijzen
AU - Hanneke W M van Laarhoven
AU - Suzanne S Gisbertz
AU - Bastiaan R Klarenbeek
AU - Paul M Jeene
AU - Roos E Pouw
AU - Loes Noteboom
AU - Rob H A Verhoeven
AU - Pauline A J Vissers
PY - 2026
DA - 2026/10/07
JO - Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
DO - 10.1007/s00520-026-11293-7
UR - https://europepmc.org/article/MED/42842001
AB - Purpose Persistent gastrointestinal symptoms are common after esophagectomy or gastrectomy, which frequently co-occur and significantly decrease quality of life. This study aimed to identify gastrointestinal symptom profiles over the first-year post-surgery and to explore changes over time.Methods Patients diagnosed between 2013 and 2024 who underwent esophagectomy or gastrectomy for nonmetastatic esophageal or gastric cancer were selected. Longitudinal self-reported gastrointestinal symptom data were linked to patient and tumor characteristics. K-means clustering based on symptom severity scores was performed at baseline and at every three months up to 12 months postoperatively. Generalized Linear Mixed Models assessed associations between patient characteristics and symptom profiles.Results Among 1462 patients who underwent esophagectomy and 434 who underwent gastrectomy, three symptom severity profiles, mild, moderate, and severe, were identified for each period. These profiles reflected increasing symptom severity rather than distinct symptom patterns. The mild symptom profile was the most common (esophagectomy: 42.5 ~ 60.5%; gastrectomy: 53.9 ~ 73.5% across time periods). Most patients remained in the same profile over time. Amongst others, female sex (esophagectomy: OR = 1.67; 95% CI:1.30-2.14, gastrectomy: OR = 1.54; 95% CI:1.07-2.23) and receiving neoadjuvant chemotherapy (esophagectomy: OR = 1.91; 95% CI:1.22-2.99, gastrectomy: OR = 2.39; 95% CI:1.55-3.67) were associated with a higher likelihood of moderate/severe symptom profile.Conclusions Three stable gastrointestinal symptom severity profiles were identified during the first postoperative year, supporting risk-stratified monitoring after upper gastrointestinal cancer surgery. Early identification of patients at risk for persistent moderate-to-severe gastrointestinal symptoms may facilitate timely supportive care and improve survivorship outcomes.
SN - 0941-4355
SN - 1433-7339
ER -