Using Quality of Life Scales with Nutritional Relevance after Gastrectomy: a Challenge for Providing Personalized Treatment

Abstract

PurposeThis study evaluated the changes in nutritional status based on quality of life (QoL) item-level analysis to determine whether individual QoL responses might facilitate personal clinical impact.Materials and MethodsThis study retrospectively evaluated QoL data obtained by the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30) and Quality of Life Questionnaire-Stomach (QLQ-STO22) as well as metabolic-nutritional data obtained by bioelectrical impedance analysis and blood tests. Patients were assessed preoperatively and at the 5-year follow-up. QoL was analyzed at the level of the constituent items. The patients were categorized into vulnerable and non-vulnerable QoL groups for each scale based on their responses to the QoL items and changes in the metabolic-nutritional indices were compared.ResultsMultiple shortcomings in the metabolic-nutritional indices were observed in the vulnerable groups for nausea/vomiting (waist-hip ratio, degree of obesity), dyspnea (hemoglobin, iron), constipation (body fat mass, percent body fat), dysphagia (body fat mass, percent body fat), reflux (body weight, hemoglobin), dry mouth (percent body fat, waist-hip ratio), and taste (body weight, total body water, soft lean mass, body fat mass). The shortcomings in a single index were observed in the vulnerable groups for emotional functioning and pain (EORTC QLQ-C30) and for eating restrictions (EORTC QLQ-STO22).ConclusionsLong-term postoperative QoL deterioration in emotional functioning, nausea/vomiting, pain, dyspnea, constipation, dysphagia, reflux, eating restrictions, dry mouth, and taste were associated with nutritional shortcomings. QoL item-level analysis, instead of scale-level analysis, may help to facilitate personalized treatment for individual QoL respondents.

Nutritional status, sarcopenia, gastrointestinal symptoms and quality of life after gastrectomy for cancer – A cross-sectional pilot study

“…Previous studies have reported total weight loss of 10e15% in the early postoperative phase [29,30]. In the long term permanent weight loss of 8.3e13.6% has been reported [7,31,32]. We observed that 45% of the patients had a persistent weight loss of >10% at follow up, which is consistent with previous findings, where 67% of subjects had >10% weight loss at two years postoperatively [12].…”

Novel Reconstruction Using Roux-en-Y Plus Antral Obstruction Following Proximal Gastrectomy: Feasibility and Quality of Life Benefits

“…This condition presents with symptoms such as an abdominal burning sensation, belching, acid reflux, and nausea and vomiting, which seriously affect postoperative diet and quality of life, thereby adversely affecting the physical and mental health of these patients. Some even suffer from depression, anxiety and malnutrition [12][13][14].…”

Whole rat stomach decellularisation using a detergent-enzymatic protocol

“…These conditions, together with the rare congenital pathology known as microgastria [ 2 ], could cause a high morbidity due to reduced gastric volume and related loss of digestive and reservoir function. Following total or partial gastrectomy, dumping syndrome and reduced intestinal adsorption of vitamins are indeed to be kept in mind dealing with children since they can influence life-long quality-of-life [ 3 ].…”