The Predictors of Health-related Quality of Life Among Adult Patients With Esophageal Cancer at Kenyatta National Hospital

Abstract

Background: Esophageal cancer is an aggressive malignancy with an increasing incidence rate and varying degrees of health-related outcomes and overall survival. There is a large and growing number of patients affected globally leading to high mortality rates establishing it as a major public health problem that stirs up a big concern requiring urgent attention. Despite its extremely aggressive nature and poor survival rate, it remains one of the least studied and deadliest cancers in Kenya. Objective: To evaluate the predictors of health-related quality of life among adult patients with Esophageal cancer at Kenyatta National Hospital. Methodology: A cross-sectional study was conducted to determine the predictors of Health-Related Quality of Life among 131 patients with esophageal cancer at cancer management units of Kenyatta National Hospital. Simple random sampling was used to select the participants. The Data was collected using a structured questionnaire and Health Related Quality of Life was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and, the Quality-of-Life Questionnaire esophageal 18. Data was analyzed using descriptive and inferential statistics at 0.05 level of significance. Statistics and data (STATA) version 13 software was used for data analysis. A bivariable and multivariable regression analysis was done to determine the predictors of Health-Related Quality of Life. Prior to the study, approval was sought from Kenyatta National Hospital Ethics and Research Committee and permission from the Kenyatta National Hospital research office. Results: The majority of respondents in this study were aged between 51 – 70 years, with an average age of 60.95 ± 12.7 years, and a more significant percentage were males. Concurrent chemoradiotherapy was the most commonly used mode of treatment for esophageal cancer. A combination of Platinum-based and Taxane-based agents was regularly used as the first line while Antimetabolites and immunotherapy were incorporated as the second line. Health Related Quality of Life was sub-optimal with an overall mean score of 45.67%, which was below average. Dysphagia, problem eating, gastrointestinal symptoms, and pain were the most significant predictors of Health-Related Quality of Life. Conclusion: Gastrointestinal symptoms were the most important predictor of Health-Related Quality of Life. Recommendation: Prospective studies should be carried out that includes the measurement of Health-related Quality of Life at baseline and after treatment, using validated instruments, such as the European Organization for Research and Treatment of Cancer Quality of Life tool or the Functional Assessment of Cancer Therapy – General in all areas of esophageal cancer management