编者按：2024年9月22日~24日，第20届世界食管疾病大会（ISDE）在苏格兰爱丁堡盛大召开。卡罗林斯卡学院Magnus Konradsson教授一项关于在食管癌确诊后一年内出现的胃肠道症状及延迟性胃通道排空症状的研究入选大会口头报告摘要展示（摘要号：OA09.04）。《肿瘤瞭望消化时讯》在大会现场针对该研究对Magnus Konradsson教授进行了专访。

肿瘤瞭望消化时讯：根据您的研究，食管癌诊断一年后患者最常见的胃肠道症状是什么？哪些策略在管理这些症状方面被证明是有效的？

Oncology Frontier: Based on your research, what are the most common gastrointestinal symptoms experienced by patients one year after esophageal cancer diagnosis, and what strategies have proven effective in managing these symptoms?

Prof. Magnus Konradsson: we have investigated gastrointestinal symptoms according to validated and widely used forms, questionnaire forms, developed by the European Organization for Researching Treatment for cancer. And from those forms, which are the C30 and OG25 forms, we have found that the symptoms early satiety, loss of appetite, regurgitation, reflux, diarrhea, epigastric pain and difficulties eating and nausea are the most common symptoms, in the order I described them, and they occur in approximately 20% of the patients reported as clinically significant.

However, the most common symptom, early satiety, is much more common compared to the other symptoms and is clinically significant, reported by 44% of the patients one year after diagnosis.So this study is conducted to provide a comprehensive description of the symptoms, both occurrence and the severity of the symptoms.

And one idea is that this can provide the foundation for further research efforts regarding what symptoms we should prioritize finding the adequate treatments for. Now, there are several studies already describing the effectiveness of treatment aimed to dilate the pylorus for facilitating emptying of the gastric conduit by balloon dilatation, and both a group in Koln and Swedish researchers, have described even dilatation with the use of 30 mm balloon, which has been shown to be effective in those cases and with less requirements for repeat treatment.

There are other studies describing also the effectiveness regarding the use of botox injection, but the most important thing is that now recently, diagnostic criteria and methods to evaluate severity for delayed gastric conduit emptying have been published and this was formed in an international consensus with a Modified Delphi Process, and such criteria are fundamental to use when evaluating treatment methods in research settings.

Magnus Konradsson教授

肿瘤瞭望消化时讯：胃道管排空延迟是如何影响患者结局和生活质量的？在临床实践中，解决这一问题的最有前景的方法是什么？

Oncology Frontier: How does delayed gastric conduit emptying impact patient outcomes and quality of life, and what are the most promising approaches for addressing this issue in clinical practice?

Prof. Magnus Konradsson: Again, the study focuses on describing the symptoms and also the symptom conflicts of the late gastric conduit emptying. It is important to mention that since this is a register based study, we are not able to evaluate the full diagnostic criteria. So we are using the symptom part of the criteria, the symptom module of the criteria. So in this study, we can only describe a patient cohort that fulfill as having delayed gastric conduit emptying one year after diagnosis. But we cannot confirm the diagnosis fully, only that the patients have symptoms that are adequately confirmed to the symptom criteria. Regarding the quality of life, interestingly, we found that among the 30% of cases that have symptoms that point to delayed gastric conduit emptying, those patients have severely lowered global health related quality of life compared to those that do not fulfill the criteria, and the difference is 23 points, which is a large difference and highly clinically, statistically significant. So clinically and statistically significant.

So when we consider what to do to treat those patients or have an effect on the quality of life for those patients, I personally want to remind that it is very important to explain for patients that have esophageal cancer what it means to undergo the surgery and that they should expect that there is a high risk of early satiety after the operation, even a while after the operation has been successfully performed and the patients have healed.And I want to emphasize the importance of giving the patients the correct expectations before they undergo the treatment.

肿瘤瞭望消化时讯：您认为未来哪些研究领域对改善食管癌患者胃胃肠道症状和胃道管排空延迟的管理最为关键？

Oncology Frontier: What areas of future research do you believe are most critical for improving the management of gastrointestinal symptoms and delayed gastric conduit emptying in esophageal cancer patients?

Magnus Konradsson教授：食管癌患者胃肠症状和胃道管排空延迟的管理至关重要。我们需要继续与大家携手，寻找共通点，并争取采用一致的方法来评估我们的治疗策略。

当前针对延迟性胃通道排空诊断标准和症状分级，当务之急是对其进行验证性研究，确认这些标准的有效性，以便我们能够准确识别出需要针对性治疗和支持的患者群体。所以，我认为当前的首要任务是验证这些诊断标准，并在未来的工作中利用它们来科学地评估治疗效果，从而为患者带来更好的治疗。

Prof. Magnus Konradsson: Thank you for this subject, the research area, it is very important that we continue to find a common ground and that we use similar methods to evaluate our treatment strategies. And for the delayed gastric conduit emptying diagnostic criteria and symptom grading 2, we now need to do validation studies and confirm the effectiveness of these diagnostic criteria to identify a patient cohort that is in need of treatment and support. So I believe the most important thing now is to validate the criteria and in future efforts to use those criteria to evaluate treatment effects.