Cognitive Impact Associated With Surgery For Gastric Or Esophageal Cancer

Karolinska Institutet130 enrolled

Overview

The primary objective of this observational study is to investigate the incidence of Post Operative Delirium (POD) after gastroesophageal cancer surgery. Secondary objectives are to investigate the relationship between POD, preoperative depression, frailty, quality of life, malnutrition and sarcopenia. Participants identified with POD will be asked (at the routine follow-up meeting after surgery) to participate in an qualitative interview, in order to understand the participant's experience of postoperative delirium. The main objective aims to answer: What is the incidence of POD after gastroesophageal cancer surgery.

Study Type

OBSERVATIONAL

Enrollment

130

Conditions

Gastroesophageal Cancer (GC)Postoperative Delirium (POD)Quality of Life (QOL)Frailty Malnutrition Sarcopenia Chemobrain

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients diagnosed with esophageal or gastric cancer, treated with (or without) chemotherapy and surgery. * Age ≥18 at the time for inclusion. * Participate on a voluntary basis and can (for any reason) end its participation during the study. * Capable of giving informed consent. Exclusion Criteria: * Patients with preoperative cognitive dysfunction such as dementia. * Patients who are inoperable due to metastases. * Patients unable to communicate due to severely impaired hearing and/or - seeing. * Patients with ongoing drug and/or alcohol abuse. * Patients who cannot give informed consent.

Outcomes

Primary Outcomes

Incidence of postoperative delirium

The assessment of cognitive function will be performed using the validated 4AT Test (4AT). Cognitive impact will be assessed at baseline before neoadjuvant chemotherapy (if chemotherapy is indicated) and at patient admission for surgery, postoperative day 1, 3 and 7, and at follow-up 4-8 weeks after surgery.

Time frame: From enrollment to the follow up meeting after surgery, approximate 6 months.

Secondary Outcomes

Preoperative depression

A risk factor for postoperative delirium is preoperative depression. Depression will be measured preoperatively with the Patient Health Questionnaire (PHQ-9).

Time frame: From enrollment to admission for surgery

Preoperative frailty

Frailty is a risk factor for post operative delirium. Frailty will be measured preoperatively with Clinical Frailty Scale (CFS-9).

Time frame: At admission for surgery

Health-related quality of life

Low score in quality of life is a risk factor for delirium. Patients will report health-related quality of life using the validated European Organisation for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire (QLQC-C30) and EORTC validated Quality of Life Questionnaire for Oesophago-Gastric cancer (QLQ-OG25).

Time frame: From enrollment to the follow up meeting after surgery, approximate 6 months.

Malnutrition

Patients with malnutrition before surgery have a higher risk of developing post-operative delirium. Malnutrition is assessed by using Patient-Generated Subjective Global Assessment (PG-SGA) before surgery.

Time frame: At admission for surgery

Sarcopenia

There is association between preoperative sarcopenia and postoperative delirium in patients undergoing gastrointestinal cancer surgery. Sarcopenia is assessed by using CT-scan in clinical routine.