Google Location History Following Oesophagectomy and/or Gastrectomy

Study Overview
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Brief Summary
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Surgery is the mainstay of treatment for patients with early-disease esophageal and gastric cancer. Open surgery for oesophageal cancer commonly involves large incisions in the chest, which is associated with a high rate of respiratory complications in the postoperative period. Patients with oesophageal or gastric cancer furthermore commonly present with significant weight loss, affecting both muscle mass and muscle strength. This could further decrease the physical fitness and increase the risk for experiencing complications after treatment. Patients also report a decreased physical functioning in quality of life at least 3 years after surgery, suggesting this is a persistent deficit. Currently, no long-term data is available assessing physical activity levels in oesophageal or gastric cancer survivors. Thus, quantifying physical activity levels in these patients may identify the period in which patients' activity levels are most likely to deteriorate. Activity levels will be assessed from Google Location History from the patient's phone, providing summary of physical activity over time. This information could be used in the future to provide adequate physical therapy intervention which might improve recovery in several aspects, such as physical fitness but also respiratory function and quality of life.

Detailed Description
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Surgery is the mainstay of treatment for patients diagnosed with early-disease esophageal and gastric cancer. Open surgery for oesophageal cancer commonly involves large incisions in the chest, which is associated with a high rate of respiratory complications in the postoperative period. Several studies have shown that low physical activity levels are associated with increased risk for respiratory complication. Furthermore, patients with oesophageal or gastric cancer often present with significant weight loss, affecting both muscle mass and muscle strength. This could further decrease the physical fitness and increase the risk for experiencing complications after treatment. Moreover, open oesophagectomy involves thoracotomy, thus impairing respiratory mechanics with further deterioration in physical fitness. Patients also report a decreased physical functioning in quality of life at least 3 years after surgery, suggesting this is a persistent deficit. Currently, no long-term data is available assessing physical activity levels in oesophageal or gastric cancer survivors. Enhanced recovery programmes are evidence-based protocols aiming at early recovery after surgery with early mobilisation and physiotherapy, and have been shown to reduce respiratory complication rates. Thus, quantifying physical activity levels in these patients may identify the period in which patients' activity levels are most likely to deteriorate and whether these changes in physical activity are associated with changes in quality of life. Activity levels will be assessed from Google Location History from the patient's phone, providing summary of patterns of physical activity over time. This information could be used in the future to provide adequate physical therapy intervention which might improve recovery in several aspects, such as physical fitness but also respiratory function and quality of life.

Official Title
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Google Location History (GLH) as a Health Tool to Assess Physical Activity Profiles and Patterns Following Oesophagectomy and/or Gastrectomy

Conditions
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Oesophageal Cancer, Gastric Cancer, Survivorship, Quality of Life

Intervention / Treatment
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* Other: Physical activity assessment


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria post-oesophagectomy or -gastrectomy group: is 18 years or older, and below 90 years of age, AND be able to walk, run or cycle a short distance, AND has been diagnosed with or already treated for oesophageal or gastric cancer if already receiving treatment, any type of treatment is included, either surgical resection for early-stage disease or definitive chemotherapy for advanced disease, AND use and Android phone Inclusion Criteria healthy controls: is 18 years or older, and below 90 years of age, AND no previous history of upper gastrointestinal cancer, AND not diagnosed with or undergoing treatment for active cancer since active cancer or cancer-related treatment might influence physical activity levels and quality of life, AND be able to walk, run or cycle a short distance, AND use an Android phone Exclusion Criteria: lacks capacity or is unable to provide informed consent, OR below 18 years of age or over 90 years of age, OR cannot walk, run or cycle a short distance, OR is diagnosed with or undergoing treatment for active cancer other than oesophageal or gastric cancer, OR is pregnant, OR is not using an Android phone, as Google Location History data is only accessible from an Android device

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 90 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Oesophagectomy<br>Patients who have undergone oesophageal cancer resection. | Other: Physical activity assessment<br>* Physical activity patterns will be obtained from google location history, using an Android phone<br>|
| Gastrectomy<br>Patients who have undergone gastric cancer resection. | Other: Physical activity assessment<br>* Physical activity patterns will be obtained from google location history, using an Android phone<br>|
| Control group<br>A cohort consisting of healthy controls who have not been diagnosed with, or have undergone treatment for oesophageal or gastric cancer. | Other: Physical activity assessment<br>* Physical activity patterns will be obtained from google location history, using an Android phone<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in physical activity pattern | The physical activity pattern will be grouped into light vs moderate vigorous activity | Data will be collected up to 5 years prior to oesophageal or gastric cancer diagnosis and up to 5 years after oesophagectomy and/or gastrectomy. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Presence of postoperative morbidity | All types of postoperative morbidity will be assessed, including postoperative pulmonary complications, neurological damage, gastrointestinal symptoms, sepsis, anastomotic leak, cardiac or renal complications, urological complications, wound infection. | Thirty-day postoperative morbidity will be collected. | 
| Health-related quality of life | The health-related quality of life will be reported using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30. | Data will be collected at time of study recruitment, with HRQoL assessed at the time of recruitment (up to 5 years after surgery). |