Long-Term Dysphagia and Regurgitation in 10-Year Esophageal Squamous Cell Carcinoma Survivors: Prevalence, Correlates, and Predictive Models in a Multi-Center Cohort

Background Dysphagia and regurgitation, the most common complications, severely impair the quality of life among survivors of esophageal squamous cell carcinoma (ESCC) after surgery. In Asian populations, where ESCC is highly prevalent, the prevalence and associated factors of these complications remain underexplored. Despite their significant impact on malnutrition, psychological distress, and long-term survival, research in this area is critically lacking. Methods We retrospectively analyzed 512 eligible 10-year esophageal squamous cell carcinoma survivors from a cohort of 4369 patients treated surgically between June 2007 and January 2014 at three hospitals. The study evaluated long-term chronic dysphagia and regurgitation, along with their associations with clinical features and lifestyle factors. Demographic, clinical, and lifestyle data were collected 6 months post-surgery, and dysphagia and regurgitation were assessed at the 10-year follow-up. Results In this study, 13.3% of participants reported chronic dysphagia, and 27.0% reported regurgitation. Multivariable logistic regression analysis showed significant associations between dysphagia and cervical anastomosis, postoperative complications, radiotherapy, and chemotherapy. An inverse relationship was found with exercise (7.5 MET-h/week) and dietary quality (CHFP-2007 score). For regurgitation, positive associations included higher income, gastrointestinal disease, insomnia, use of Chinese patent medicine or trace element supplementation, and smoking, while higher dietary quality was protective. Nomograms accurately predicted dysphagia (AUC = 0.876) and regurgitation (AUC = 0.769). Conclusion The prevalence of dysphagia and regurgitation among long-term esophageal squamous cell carcinoma survivors in China is high, presenting a significant health concern. Key correlates include the location of anastomosis, postoperative interventions, dietary quality, socioeconomic status, and concurrent health issues. These findings highlight the need for holistic care approaches, including tailored dietary and lifestyle adjustments, to alleviate these symptoms in long-term esophageal squamous cell carcinoma survivors post-esophagectomy.