Health-related quality of life after gastric cancer treatment in Brazil: Narrative review and reflections

Abstract

In Brazil, gastric cancer is the third most common type of cancer among men and fifth among women, with an estimated 13360 new cases among men and 7870 among women each year during the 2020-2022 period. This study presents reflections and attempts to add knowledge to the theme of quality of life (QoL) in patients with gastric adenocarcinoma and describes some of its characteristics in three regions of Brazil, with an evaluation of the disease’s impacts in various dimensions of life, as reported by the patients themselves. We performed a narrative review of the literature and a data analysis of studies on QoL in Brazilian patients treated for gastric adenocarcinoma from three different cities in three geographic regions: Brasília (the midwest), Jaú (the southeast), and Macapá (the north).

Influence of the centralizing gastric cancer surgery on the health-related quality of life in Brazil

“…It is validated for a Brazilian population, consisting of 36 items encompassed in 8 domains: functional capacity, physical aspects, pain, general health, vitality, social aspects, emotional aspects, and mental health. Each question is assigned a value in grades from 8 domains ranging from 0= to 100= best, for each domain ( 2 , 6 ).…”

“…Surgery is considered a potentially curative therapy. However, the interdisciplinary approach is a determinant of improvement in results ( 2 - 5 ). Furthermore, even the best treatment obtaining a cure for the tumor can result in adverse effects on the quality of life (QoL) of these patients, making it challenging to balance the treatment standardized and the best outcome ( 2 , 4 , 5 ).…”

“…The complete concept of “quality of life” is still poorly understood by some authors who may not be familiar with these assessments according to the definition suggested by the World Health Organization (WHO), which considers the multidimensional and subjective factors of quality of life and defines it as the individual’s perception of their position in life, in the context of the culture and value system in which they live and place their standards and expectations ( 2 , 4 , 5 ). This concept incorporates aspects such as life experiences, well-being, satisfaction, social and physical functions, which are influenced by physical, socioeconomic, psychological factors, perception of health status and general satisfaction with life ( 2 , 4 - 6 ).…”

“…The assessment of the QoL can be performed using validated and reproducible instruments in different languages, which usually address the environmental, social, occupational, physical, psychological and spiritual relationships, always maintaining a multidimensional character and evaluating the general perception of quality of life emphasizing the symptoms or limitations resulting from a disease ( 2 ). The instruments can be generic (when applicable non-specifically to different conditions and can be used in the general population), or specific (appropriate to the patient with one particular disease or symptom) ( 4 - 6 ).…”

“…The study of the QoL outcome can also be used in public health management, enlightening valuable population information that, together with classical morbidity and mortality analysis data, may support the best decisions in planning lines of care in oncology, especially in gastric cancer ( 2 , 6 ). The medical literature is abundant in describing the prognostic and technical advantages of specific surgical training associated with a large volume of cases and hospitals dedicated to this disease.…”