Development of a symptom response to treatment questionnaire for patients in follow-up after oesophago-gastrectomy for cancer

Abstract Objectives This study aimed to develop and evaluate a symptom response to treatment questionnaire tailored for patients following oesophago-gastrectomy for cancer. The goal was to create a tool that could reliably assess changes in symptom frequency, severity, and overall improvement in response to post-operative treatments. Methods A multidisciplinary team designed the questionnaire based on patient feedback and a prior survey of 362 patients which identified 36 key symptoms after surgery. The questionnaire incorporated validated items from the European Organization for Research and Treatment of Cancer (EORTC) and was registered with EORTC. A total of 24 patients participated in the initial development phase, providing feedback alongside semi-structured interviews. The revised questionnaire was then reviewed by 16 patients in outpatient and endoscopy settings. The utility of the questionnaire was further tested in a cohort of 50 patients treated for delayed gastric conduit emptying (DGCE) post-oesophago-gastrectomy, with follow-up conducted at 2- and 4-weeks post-intervention. Results All 24 patients (100%) in the initial development phase found the questionnaire easy to understand, with 83.3% (20/24) preferring Likert scales to assess symptom improvement. In the subsequent review by 16 patients, 93.8% (15/16) found the questionnaire easy or very easy to complete, and 87.5% (14/16) were open to an online version. In the DGCE cohort, 98% of patients (50/51) completed follow-up with 82% (41/50) very happy and 18% (9/50) happy to complete the questionnaire. Clinical utility was demonstrated with improved symptom frequency and severity after endoscopic pyloric dilatation (P < 0.01). Conclusion The symptom response to treatment questionnaire shows promise as an effective tool for monitoring post-operative symptoms in oesophago-gastrectomy patients with high patient satisfaction and significant clinical utility.