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

Brenkman, Hylke J. F.; Tegels, Juul J. W.; Ruurda, Jelle P.; Luyer, Misha; Kouwenhoven, Ewout A.; Draaisma, Werner A.; Peet, Donald L. van der; Wijnhoven, Bas P. L.; Stoot, Jan H.M.B.; Hillegersberg, Richard van

doi:10.1007/s10120-017-0771-0

Cited by 48 publications

(52 citation statements)

References 32 publications

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“…In another article, there was no difference between the patients who underwent adjuvant chemotherapy and those who did not undergo adjuvant chemotherapy [ 24 ]. Nevertheless, another study published in 2018 showed that the role functioning scale and reflux scale were good in the advanced stage (>stage II); that is similar to our analysis [ 25 ]. It seems that the experience of survival from cancer might change the threshold of an individual's satisfaction.…”

Section: Discussionsupporting

confidence: 91%

“…Referring to a well-designed study that compared QOL before and after coronary artery bypass surgery, they concluded that the baseline level of QOL and the change of QOL by surgery differed according to sex [ 27 28 ]. Interestingly, an article about gastric surgery presented results similar to ours in terms of sex differences [ 25 ]. Therefore, our clinicians might keep in mind that the ratio of males and females affects the outcomes of the QOL study.…”

Section: Discussionsupporting

confidence: 59%

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The pattern of postoperative quality of life following minimally invasive gastrectomy for gastric cancer: a prospective cohort from Korean multicenter robotic gastrectomy trial

et al. 2020

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Purpose Quality of life (QOL) has become important in the trend of emphasizing patient satisfaction. This study aimed to evaluate the QOL in patients who underwent laparoscopic or robotic gastrectomy for gastric cancer. Methods A prospective trial was performed involving patients who underwent laparoscopic or robotic gastrectomy for primary gastric cancer at 11 hospitals in Korea. Within this comparative trial, QOL, postoperative pain, and long-term complications were exanimated. The quality-of-life questionnaire (QLQ)-C30 and QLQ-STO22 developed by the European Organization for Research and Treatment of Cancer were used for the QOL survey. We compared the data after dividing it into several types of characteristics as follows; device (robotic or laparoscopic), operation type, pathological stage, and sex. Biased components were extracted by logistic regression analysis. Propensity score matching was applied to the data set with the biased components. Results In total, 434 patients (211 for laparoscopic surgery and 223 for robotic surgery) were enrolled, out of which 321 patients who responded to both preoperative and postoperative surveys were selected for analysis. Robotic gastrectomy was not different from laparoscopic gastrectomy with respect to postoperative QOL. Distal gastrectomy showed better scores than total gastrectomy in terms of role functioning, social functioning, fatigue, nausea/vomiting, pain, dyspnea, constipation, financial difficulties, dysphagia, eating restrictions, anxiety, taste, and body image. Male patients showed better scores on the 19 scales compared to female patients. Conclusion Robotic and laparoscopic approaches for gastric cancer surgery did not differ from each other with respect to QOL. Distal gastrectomy resulted in better QOL than total gastrectomy.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 59%

The pattern of postoperative quality of life following minimally invasive gastrectomy for gastric cancer: a prospective cohort from Korean multicenter robotic gastrectomy trial

et al. 2020

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“…In addition, pre-operative evaluation of a patients' condition, for instance, the vascular status [33], may contribute to select and treat patient who are prone for developing anastomotic leakage. Moreover, if an adequate oncologic resection is possible, subtotal gastrectomy should be preferred over total gastrectomy, as the former results in a lower risk of postoperative complications and better quality of life [34,35]. Finally, special intraoperative attention should be paid to the perfusion of and tension on the anastomosis and its staple-line technique (hand sewn versus stapler and linear versus circular) and reinforcement to avoid leakage and support the healing process [36,37].…”

Section: Discussionmentioning

confidence: 99%

Identification of the clinically most relevant postoperative complications after gastrectomy: a population-based cohort study

et al. 2019

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Background Postoperative complications frequently occur after gastrectomy for gastric cancer and are associated with poor clinical outcomes, such as mortality and reoperations. The aim of study was to identify the clinically most relevantcomplications after gastrectomy, using the population-attributable fraction (PAF). Methods Between 2011 and 2017, all patients who underwent potentially curative gastrectomy for gastric adenocarcinoma were included from the Dutch Upper GI Cancer Audit. Postoperative outcomes (morbidity, mortality, recovery and hospitalization) were evaluated. The prevalence of postoperative complications (e.g., anastomotic leakage and pneumonia) and of the study outcomes were calculated. The adjusted relative risk and Confidence Interval (CI) for each complication-outcome pair were calculated. Subsequently, the PAF was calculated, which represents the percentage of a given outcome occurring in the population, caused by individual complications, taking both the relative risk and the frequency in which a complication occurs into account. Results In total, 2176 patients were analyzed. Anastomotic leakage and pulmonary complications had the greatest overall impact on postoperative mortality (PAF 29.2% [95% CI 19.3-39.1] and 21.6% [95% CI 10.5-32.7], respectively) and prolonged hospitalization (PAF 12.9% [95% CI 9.7-16.0] and 14.7% [95% CI 11.0-18.8], respectively). Anastomotic leakage had the greatest overall impact on re-interventions (PAF 25.1% [95% CI 20.5-29.7]) and reoperations (PAF 30.3% [95% CI 24.3-36.3]). Intra-abdominal abscesses had the largest impact on readmissions (PAF 7.0% [95% CI 3.2-10.9]). Other complications only had a small effect on these outcomes. Conclusion Surgical improvement programs should focus on preventing or managing anastomotic leakage and pulmonary complications, since these complications have the greatest overall impact on clinical outcomes after gastrectomy.

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“…Furthermore, PA declines more markedly in patients who have undergone gastrectomy and are receiving postoperative chemotherapy or chemoradiation [11]. Moreover, patients with GC encounter significant functional impairments and decreased quality of life because of decreased PA and increased gastrointestinal symptoms [12]. Despite the deterioration in physical function, regular PA (to strengthen muscle power, which leads to improved physical function), proper nutritional intervention (to improve food intake, which results in weight gain), and mental support (to preserve self-esteem and maintain social activity) may help in restoring the patients’ health status and improving quality of life [13].…”

Section: Introductionmentioning

confidence: 99%

Wearable-Based Mobile Health App in Gastric Cancer Patients for Postoperative Physical Activity Monitoring: Focus Group Study

Wu¹,

Ho²,

Chang³

et al. 2019

JMIR Mhealth Uhealth

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Background Surgical cancer patients often have deteriorated physical activity (PA), which in turn, contributes to poor outcomes and early recurrence of cancer. Mobile health (mHealth) platforms are progressively used for monitoring clinical conditions in medical subjects. Despite prevalent enthusiasm for the use of mHealth, limited studies have applied these platforms to surgical patients who are in much need of care because of acutely significant loss of physical function during the postoperative period. Objective The aim of our study was to determine the feasibility and clinical value of using 1 wearable device connected with the mHealth platform to record PA among patients with gastric cancer (GC) who had undergone gastrectomy. Methods We enrolled surgical GC patients during their inpatient stay and trained them to use the app and wearable device, enabling them to automatically monitor their walking steps. The patients continued to transmit data until postoperative day 28. The primary aim of this study was to validate the feasibility of this system, which was defined as the proportion of participants using each element of the system (wearing the device and uploading step counts) for at least 70% of the 28-day study. “Definitely feasible,” “possibly feasible,” and “not feasible” were defined as ≥70%, 50%-69%, and <50% of participants meeting the criteria, respectively. Moreover, the secondary aim was to evaluate the clinical value of measuring walking steps by examining whether they were associated with early discharge (length of hospital stay <9 days). Results We enrolled 43 GC inpatients for the analysis. The weekly submission rate at the first, second, third, and fourth week was 100%, 93%, 91%, and 86%, respectively. The overall daily submission rate was 95.5% (1150 days, with 43 subjects submitting data for 28 days). These data showed that this system met the definition of “definitely feasible.” Of the 54 missed transmission days, 6 occurred in week 2, 12 occurred in week 3, and 36 occurred in week 4. The primary reason for not sending data was that patients or caregivers forgot to charge the wearable devices (>90%). Furthermore, we used a multivariable-adjusted model to predict early discharge, which demonstrated that every 1000-step increment of walking on postoperative day 5 was associated with early discharge (odds ratio 2.72, 95% CI 1.17-6.32; P =.02). Conclusions Incorporating the use of mobile phone apps with wearable devices to record PA in patients of postoperative GC was feasible in patients undergoing gastrectomy in this study. With the support of the mHealth platform, this app offers seamless tracing of patients’ recovery with a little extra burden and turns subjective PA into an objective, measurable parameter.

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

Cited by 48 publications

References 32 publications

The pattern of postoperative quality of life following minimally invasive gastrectomy for gastric cancer: a prospective cohort from Korean multicenter robotic gastrectomy trial

The pattern of postoperative quality of life following minimally invasive gastrectomy for gastric cancer: a prospective cohort from Korean multicenter robotic gastrectomy trial

Identification of the clinically most relevant postoperative complications after gastrectomy: a population-based cohort study

Wearable-Based Mobile Health App in Gastric Cancer Patients for Postoperative Physical Activity Monitoring: Focus Group Study

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