Longitudinal trends of dumping syndrome after oesophageal cancer surgery

Background and aims: Postprandial dumping syndrome is a common complication after oesophageal cancer surgery. However, its long-term progression and effects on weight loss remain unknown. This study evaluates the prevalence of dumping syndrome longitudinally and its relationship with eating difficulties and weight loss.
Methods: The study is part of the prospective nationwide Swedish cohort OSCAR. Patients were included one year post-surgery (2014–2021), data up to five years post-surgery were analysed. Dumping syndrome was assessed using the OSCAR Dumping Questionnaire, classifying early and late subtypes by severity. Eating difficulties were measured with the validated EORTC QLQ-OG25 questionnaire. Weight was obtained from medical records (preoperative), objective measurements (one-year baseline), and self-reports (follow-ups).
Results: Among 385 patients, 50.9% had early (19.0% severe) and 10.9% late (3.1% severe) dumping syndrome one year post-surgery. Five years post-surgery (n=101), 57.5% reported early and 12.8% late dumping, without significant change in severity. Severe dumping was associated with higher
eating difficulty scores (p<0.001) one year but not five years post-surgery. Severe early dumping was associated to greater weight loss (%) – mean difference (MD) 2.8 (95% Confidence Interval (CI): 0.5-5.1) one year and MD 5.6 (95% CI: 1.4-9.7) five years post-surgery.
Conclusion: Dumping syndrome is prevalent and persistent after oesophageal cancer surgery. However, patients tend to misreport their symptoms, highlighting the need for a validated diagnostic tool. Severe dumping is associated with eating difficulties and weight loss, suggesting the need for dietary support. However, eating experience and weight improve over time, even in patients with persistent dumping syndrome.