Long-term Shifting Patterns in Quality of Life After Distal Subtotal Gastrectomy

Lee, Seung Soo; Chung, Ho Young; Kwon, Ohkyoung; Yu, Wansik

doi:10.1097/sla.0000000000000832

Cited by 17 publications

(22 citation statements)

References 26 publications

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“…In addition, the anxiety score was highest at 1 year after surgery, and decreased to the preoperative level 5 years after gastrectomy [1819]. Patients' worsened body image did not return to preoperative levels during the 5 years after gastrectomy [20]. In our study, changes in the proportions of patients reporting poor QoL in relation to emotional functioning, anxiety scale, and body image items were similar to those of previous studies.…”

Section: Discussionsupporting

confidence: 86%

“…Although the preoperative QoL was not altered by surgery, it might represent a patient's QoL after the diagnosis of gastric cancer. A preoperative-based interpretation of postoperative change in QoL may not only exaggerate the persistence of a decreased QoL but also conceal ongoing QoL deterioration after surgery [20]. However, obtaining data regarding patient QoL before the diagnosis of gastric cancer is not feasible in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

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Chronological Changes in Quality of Life after Distal Gastrectomy for Gastric Cancer

et al. 2017

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PurposePatient quality of life (QoL) may be severely disrupted following distal gastrectomy for gastric cancer. This issue should be addressed to improve postoperative care.Materials and MethodsQoL data from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, and its gastric cancer-specific module, were administered to 202 patients preoperatively, and 5 years postoperatively. Patients were classified into subgroups based on their answers to each questionnaire item: group I (good), answering “not at all”; group II (fair), answering “a little”; group III (poor), answering “quite a bit” or “very much.”ResultsAt 5 years post-operation, the proportion of patients in group III on the functional scales ranged from 4.3% to 5.7%. The proportions of patients in group III with fatigue, insomnia, diarrhea, and financial difficulties were 8.9%, 9.0%, 11.5%, and 9.1%, respectively. The proportions of patients in group III with anxiety, dry mouth, body image concerns, and hair loss were 12.8%, 10.5%, 9.9%, and 12.6%, respectively. These proportions were less than 5% for other QoL symptom scales/items and for the gastric cancer-specific module.ConclusionsMost patients reported good or fair QoL following surgery. However, symptom management of fatigue, insomnia, diarrhea, anxiety, dry mouth, body image, and hair loss should be specifically targeted for long-term patient care in approximately 10% of patients.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Chronological Changes in Quality of Life after Distal Gastrectomy for Gastric Cancer

et al. 2017

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“…The results further showed additional benefits of fewer overall and minor complications, shorter length-of-stay (Weighted Mean Difference -3.6 days) and less blood loss [69]. Also, a longer operation time and lower number of harvested Table 2) [69][70][71][72][73]. The general conclusion of these studies is that the laparoscopic approach offers improved recovery after surgery at no compromise of morbidity and mortality.…”

Section: Laparoscopic Surgerymentioning

confidence: 84%

“…Other studies to date have been mostly in Asian populations. As mentioned previously, there are important differences between Eastern and Western gastric cancer patients and their treatment [71][72][73]. One other Western study also found profound impact on HRQoL immediately after surgery and showed some improvement over the next six months [74].…”

Section: Health Related Quality Of Life After Gastric Cancer Surgerymentioning

confidence: 92%

“…This means that even though there are measurable impairments in different areas of life, overall HRQoL is determined by other factors and can because of that be comparable to the general population. An example of this from another study is that it is even possible to find higher global HRQoL in patients who underwent distal gastrectomy [72]. These patients, who underwent partial gastrectomy for cancer, also experienced more symptoms but had higher global HRQoL than a reference population [72].…”

Section: Health Related Quality Of Life After Gastric Cancer Surgerymentioning

confidence: 95%

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Improving outcomes in gastric cancer surgery

Juul¹,

Jw²,

Tegels³

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Factors influencing health-related quality of life after gastrectomy for cancer

et al. 2017

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AimInsight in health-related quality of life (HRQoL) may improve clinical decision making and inform patients about the long-term effects of gastrectomy. This study aimed to evaluate and identify factors associated with HRQoL after gastrectomy.MethodsThis cross-sectional study used prospective databases from seven Dutch centers (2001–2015) including patients who underwent gastrectomy for cancer. Between July 2015 and November 2016, European Organization for Research and Treatment of Cancer HRQoL questionnaires QLQ-C30 and QLQ-STO22 were sent to all surviving patients without recurrence. The QLQ-C30 scores were compared to a Dutch reference population using a one-sample t test. Spearman’s rank test was used to correlate time after surgery to HRQoL, and multivariable linear regression was performed to identify factors associated with HRQoL.ResultsA total of 222 of 274 (81.0%) patients completed the questionnaires. Median follow-up was 29 months (range, 3–171) and 86.9% of patients had a follow-up >1 year. The majority of patients had undergone neoadjuvant treatment (64.4%) and total gastrectomy (52.7%). Minimally invasive gastrectomy (MIG) was performed in 50% of the patients. Compared to the general population, gastrectomy patients scored significantly worse on most functional and symptom scales (p < 0.001) and slightly worse on global HRQoL (78 vs. 74, p = 0.012). Time elapsed since surgery did not correlate with global HRQoL (Spearman’s ρ = 0.06, p = 0.384). Distal gastrectomy, neoadjuvant treatment, and MIG were associated with better HRQoL (p < 0.050).ConclusionAfter gastrectomy, patients encounter functional impairments and symptoms, but experience only a slightly impaired global HRQoL. Distal gastrectomy, the ability to receive neoadjuvant treatment, and MIG may be associated with HRQoL benefits.Electronic supplementary materialThe online version of this article (doi:10.1007/s10120-017-0771-0) contains supplementary material, which is available to authorized users.

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Long-term Shifting Patterns in Quality of Life After Distal Subtotal Gastrectomy

Cited by 17 publications

References 26 publications

Chronological Changes in Quality of Life after Distal Gastrectomy for Gastric Cancer

Chronological Changes in Quality of Life after Distal Gastrectomy for Gastric Cancer

Improving outcomes in gastric cancer surgery

Factors influencing health-related quality of life after gastrectomy for cancer

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