Chronological changes in quality of life and body composition after gastrectomy for locally advanced gastric cancer

Abstract

Despite progress in cancer treatment, surgical resection is the primary treatment option for advanced gastric cancer. Unlike early stages of gastric cancer, in which function preserving gastrectomy can be performed, distal subtotal gastrectomy or total gastrectomy (TG) is the standard treatment for advanced gastric cancer [1]. However, postgastrectomy symptoms due to surgical resection, which result in loss of reservoir capacity, are inevitable. These postgastrectomy symptoms lead to deterioration in patient quality of life (QoL) and body composition (BC) status and can vary depending on the extent of the gastrectomy [2].Patient survival is always the highest priority in the treatment

Health-Related Quality of Life in Locally Advanced Gastric Cancer: A Systematic Review

“…Two studies did not describe a difference between the type of surgery [ 30 , 33 ]. This outcome is in contrast to the results of Park et al, and Brenkman et al [ 34 , 35 ]. Park et al, described worse long-term HRQOL in patients who underwent a total gastrectomy compared to distal gastrectomy, in both functioning (physical and role) as well as seven symptom scores (fatigue, pain, reflux, eating restrictions, anxiety, taste, and body image) [ 35 ].…”

“…This outcome is in contrast to the results of Park et al, and Brenkman et al [ 34 , 35 ]. Park et al, described worse long-term HRQOL in patients who underwent a total gastrectomy compared to distal gastrectomy, in both functioning (physical and role) as well as seven symptom scores (fatigue, pain, reflux, eating restrictions, anxiety, taste, and body image) [ 35 ]. Brenkman et al, also described a better HRQOL in patients undergoing distal gastrectomy, as well as treatment with minimal invasive surgery in a multivariate analysis [ 34 ].…”

“…However, Brenkman et al, showed, in a multivariate analysis, that patients who received a distal gastrectomy or minimal invasive surgery had better HRQOL, especially on the gastrointestinal subscales [ 34 ]. Park et al, described worse HRQOL in patients who underwent a total gastrectomy compared to distal gastrectomy > 1 years after surgery [ 35 ].…”

Are the elderly patient's changes in the health-related quality of life one year after gastrectomy for stomach cancer different from those in young patients?

“…Lastly, this study lacked long-term results and the strategy to reduce the missing data or the cross-sectional study design may help this limitation. But when we reviewed the previous studies which showed that time trend is mainly associated with HRQoL in the early recovery period whereas HRQoL remains relatively stable after the 1st year following surgery [5,15,16,23], similar long-term results were expected. Future research includes (1) nonlinear trend over the course of follow-up using the nonlinear mixed effects model; (2) the time-varying nutrition in the regression model to better understand the impact of the nutrition on the HRQoL of the patient.…”

“…Except for age groups, other factors related to HRQoL identified in this study were time trend, sex, total gastrectomy, laparoscopic gastrectomy, and postoperative chemotherapy. Total gastrectomy was known to have more negative effect on HRQoL than distal gastrectomy [5,7,8,[14][15][16][17], which preserves more stomach and requires a less extensive lymphadenectomy. The lower HRQoL of women was consistent with other studies [5,18].…”