Quality of Life in Disease-Free Gastric Adenocarcinoma Survivors: Impacts of Clinical Stages and Reconstructive Surgical Procedures

Abstract

Aim: To investigate health-related quality of life data of disease-free gastric adenocarcinoma survivors, with special emphasis on the roles of clinical stages and reconstructive surgical procedures. Methods: We performed a cross-sectional study in 51 disease-free gastric adenocarcinoma patients. The patients had been followed for at least 6 (median 17, range from 6 months to 2 years) months after initial radical surgery. The Taiwan Chinese version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Cancer 30 (EORTC QLQ-C30) and the supplementary gastric cancer module QLQ-STO22 were used as outcome measures. Results: Patients with earlier-/advanced-stage diseases (American Joint Committee on Cancer stages I and II vs. III and IV) had a similar quality of life in terms of global health status and functional and symptomatic well-being. Subtotal gastrectomy outweighed total gastrectomy with better role function and less nausea/vomiting and appetite loss. Multivariate regression analyses also proved that proximal gastric preservation was predictive of better role function, less nausea/vomiting, and less appetite loss. Conclusions: Gastric adenocarcinoma survivors may enjoy a similar life quality, regardless of their original disease stages. Functional preservation may have marginal advantages to improve patients’ quality of life by reducing symptomatic nausea, vomiting, and appetite loss postoperatively.

Quality of life beyond the early postoperative period after laparoscopy-assisted distal gastrectomy: the level of patient expectation as the essence of quality of life

“…There have been studies comparing the QoL of gastric cancer patients after distal subtotal gastrectomy and total gastrectomy [18][19][20]. In the early postoperative period, patients who underwent distal subtotal gastrectomy experienced better QoL than patients who underwent total gastrectomy, but the QoL benefits of distal subtotal gastrectomy were lost as time elapsed.…”

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

“…However, many of these studies investigated the QoL of patients with unresolved oncological problems (20)(21)(22). The QoL of long-term survivors has also been investigated, but most of these studies examined the impact of procedural differences on the QoL of patients who underwent surgery for gastric cancer (18)(19)(20).…”

Characteristics and clinical relevance of postgastrectomy syndrome assessment scale (PGSAS)-45: newly developed integrated questionnaires for assessment of living status and quality of life in postgastrectomy patients

“…This goal is particularly important in the Far East where gastric cancer is often found at early clinical stages so that more patients manage to survive their cancer and consequently need to face the PGS in the long term [9]. It is known that the type of gastrectomy affects the incidence and severity of PGS [10][11][12][13][14][15][16][17][18][19][20][21], and various procedures to preserve or reconstruct gastric function have been proposed to confront these problems [7,8]. To gain deeper understanding of the PGS, a group of iatrogenic disorders, and treat them appropriately, it is important to grasp the impact of various symptoms, along with feeding problems and body weight loss, to the living status and QOL of the patients.…”

“…A combination of SF-36, a core questionnaire, and GSRS, a symptom-specific QOL, has been one of the examples [11,14], but the GSRS may have a tendency to overlook some of the symptoms that are peculiar to the patients who have undergone gastrectomy and are unusual for other disorders of the gastrointestinal tract. EORTC QLQ-C30 [25], a cancer-specific core questionnaire, and STO-22 [26] is another combination that has been used to evaluate postgastrectomy patients [12,13]. However, these questionnaires have been developed to evaluate QOL of the patients who are burdened with cancer and are receiving treatments rather than those who became cancer free through surgery but are suffering from PGS.…”