Postoperative quality of life after gastrectomy in gastric cancer patients: a prospective longitudinal observation study

Abstract

Purpose The European Organization for Research and Treatment of Cancer quality of life (QOL) questionnaires (QLQ-C30, QLQ-OG25, and QLQ-STO22) are widely used for the assessment of gastric cancer patients. This study aimed to use these questionnaires to evaluate QOL in postgastrectomy patients. Methods We prospectively evaluated 106 patients with distal gastrectomy (DG), 57 with pylorus-preserving gastrectomy (PPG), and 117 with total gastrectomy (TG). Body weight and QOL questionnaires were evaluated preoperatively and postoperatively (at 3 weeks, and 3, 6, and 12 months). Results TG patients had significantly more weight loss than DG/PPG patients. Compared with DG, patients after PPG had less dyspnea (P = 0.008) and trouble with coughing (P = 0.049), but more severe symptoms of insomnia (P = 0.037) and reflux (P = 0.030) at postoperative 12 months. Compared with DG/PPG, TG was associated with worse body image, dysphagia, eating, and taste in both OG25 and STO22. Moreover, OG25 revealed worse QOL in the TG group with respect to odynophagia, eating with others, choked when swallowing, trouble talking, and weight loss. The QOL of patients who received chemotherapy was worse than those in the chemo-free group in both physical functioning and symptoms such as nausea/vomiting, appetite loss, and trouble with taste; however, these side effects would soon disappear after finishing chemotherapy. Conclusion PPG was similar to DG in terms of postoperative QOL and maintaining body weight, while TG was always inferior to both DG and PPG. Adjuvant chemotherapy can affect both body weight and QOL despite being reversible.

Comparison between laparoscopic pylorus-preserving gastrectomy and laparoscopic distal gastrectomy for overweight patients with early gastric cancer

“…We speculate that the difficulty of lymph node dissection around the infrapyloric area with preservation of infrapyloric vessels in overweighted patients might have resulted in direct or indirect injuries around the pylorus. These injuries possibly decreased the function of the pylorus and limited food uptake by delayed gastric emptying and/or loss of appetite [ 20 ], although it may not be proven without gastric emptying time test.…”

Impact on quality of life with affirmative feedback on weight loss after gastrectomy

“…None of the patients underwent neoadjuvant chemotherapy. Those with higher stage cancer were not included, because advanced cancer status and consequent additional treatment efforts such as adjuvant chemotherapy might have a sustained impact on patients’ QoL and body weight 21 , 22 . Preoperatively overweight or patients with obesity (BMI ≥ 23.0 kg/m 2 ) experiencing significant weight loss, with a total loss of ≥ 10% of their preoperative weight at the postoperative 1-year follow-up, were identified (Fig.…”

Health‐related quality of life among patients with esophageal, gastric, and colorectal cancer at Kenyatta National Hospital

“…From diagnosis to treatment, cancer survivors face mental, physical, and economic challenges and confusion regarding their social roles 4 . Numerous studies have demonstrated that cancer treatment adversely affects the HRQoL of patients 5–11 . In developing countries, HRQoL is generally low among cancer patients 12,13 .…”

“… 4 Numerous studies have demonstrated that cancer treatment adversely affects the HRQoL of patients. 5 , 6 , 7 , 8 , 9 , 10 , 11 In developing countries, HRQoL is generally low among cancer patients. 12 , 13 A recent systematic review showed that most cancer patients had a suboptimal overall HRQoL in Sub‐Saharan Africa.…”