EUropean consensus on the Resolution Of SympToms After oesophago-gastric Resection (EUROSTAR): Peri-Operative Quality Initiative (POQI) consensus statement.
Abstract
Background
Symptoms after upper gastrointestinal (UGI) cancer surgery are common, frequently overlap, and can substantially affect quality of life. Despite increasing recognition of this problem, there is limited standardisation in the definition, investigation and management of the postoperative conditions responsible for these symptoms.
Methods
A society-endorsed, European-wide series of consensus meetings was conducted using a modified Delphi process developed by the PeriOperative Quality Initiative (POQI). A multidisciplinary panel of experts from 10 European countries, selected for their expertise in UGI cancer survivorship, participated in the development of consensus-based recommendations for symptoms following major UGI cancer surgery. Independent oversight was provided by POQI, and statements and recommendations were graded using a modified GRADE methodology informed by a comprehensive literature review.
Results
A total of 8 statements and 13 recommendations relating to symptom monitoring and service provision after major UGI cancer surgery were developed, refined and agreed upon through a preliminary meeting and two semistructured POQI consensus meetings. Diagnostic criteria, investigation pathways and management recommendations for the common postoperative conditions encountered after UGI cancer surgery were also developed and refined through multidisciplinary discussion before achieving consensus. 16 future research priorities were identified.
Conclusions
The EUROSTAR consensus provides guidance on symptom monitoring, service provision and the investigation and management of common postoperative conditions following UGI cancer surgery. These recommendations represent an important step towards standardising survivorship care and supporting future research in this patient population.