Quality of life after curative gastrectomy for gastric cancer in a randomised controlled trial

Abstract

Quality of life (QOL) was studied in gastric cancer patients treated on a randomised, controlled trial comparing D1 (level 1) with D3 (levels 1, 2 and 3) lymphadenectomy. A total of 221 patients were randomly assigned to D1 (n ¼ 110) and D3 (n ¼ 111) surgery. Quality-of-life assessments included functional outcomes (a 14-item survey about treatment-specific symptoms) and health perception (Spitzer QOL Index) was performed before and after surgery at disease-free status. Patients suffered from irrelative events such as loss of partners was excluded thereafter. Main analyses were done by intention-to-treat. Thus, 214 D1 (106/ 110 ¼ 96.4%) and D3 (108/111 ¼ 97.3%) R0 patients were assessed. Longitudinal analysis showed that functional outcomes decreased at 6 months after surgery and increased over time thereafter, while health perceptions increased over time in general. On the basis of linear mixed model analyses, patients having total gastrectomy, advanced cancer and hemipancreaticosplenectomy, but not complications had poorer QOL than those without. D1 and D3 patients showed no significant difference in QOL. The results suggest that changes of QOL were largely due to scope of gastric resection, disease status and distal pancreaticosplenectomy, rather than the extent of lymph node dissection. This indicates that nodal dissection can be performed for a potentially curable gastric cancer.

Quality of Life of Long-Term Survivors after a Distal Subtotal Gastrectomy

“…However, most of them compared the QoL of gastric cancer patients by the surgical approach only. For example, they compared QoL by different levels of lymph node dissections or by different techniques (17)(18)(19). Few studies have examined the QoL of long-term survivors from gastric cancer using the EORTC QLQ-C30 and QLQ-STO22.…”

Evaluating the Impact on Quality of Life of Chemoradiation in Gastric Cancer

“…All patients in our study had undergone radical surgery before they commenced adjuvant treatment. Several research groups, using a variety of instruments [Short Form (SF-36) Health Survey, D15, Spitzer Quality of Life Index, eortc qlq-C30 and -STO22], have reported a reduction in qol in similar populations [18][19][20][21] .…”

Outcome 1 year after digestive surgery in malnourished, elderly patients, with an emphasis on quality of life analysis

“…Previous studies have shown that 3-6 months 10,11,22 are needed to achieve the preoperative quality of life after major abdominal surgery. We further considered that some patients would have chemotherapy (usually for 6 months in the adjuvant setting starting within 2 months after surgery).…”