Quality of life after gastrectomy for adenocarcinoma: A prospective cohort study Journal Article

Authors: Karanicolas, P. J.; Graham, D.; Gonen, M.; Strong, V. E.; Brennan, M. F.; Coit, D. G.
Article Title: Quality of life after gastrectomy for adenocarcinoma: A prospective cohort study
Abstract: Background: Gastrectomy remains a major operation with potential for significant deterioration in patients' health-related quality of life (QOL). This study assessed differences in QOL among patients after distal (DG), proximal (PG), or total (TG) gastrectomy. Methods: We prospectively enrolled patients undergoing gastrectomy at our institution between 2002 and 2007. Participants completed the European Organization for Research and Treatment of Cancer cancer (QLQ-C30) and gastric (QLQ-STO22) questionnaires preoperatively and at 5 postoperative intervals up to 18 months. We compared changes from baseline in patients based on extent of resection (proximal, distal, or total) using generalized linear models, adjusting for age, stage of disease, and (neo)adjuvant therapy. We converted QOL raw scores to reflect the proportion of patients with clinically significant deterioration based on the minimal important difference. Results: We included 134 patients: 82 DG, 16 PG, and 36 TG. In the immediate postoperative period, 55% of patients suffered significant impairment in their global QOL. This improved in most patients by 6 months, although 20% to 35% continued to have substantially worse QOL than before surgery. Patients who underwent PG suffered from significantly more clinical reflux [70% vs 35% (DG), 40% (TG)], nausea/vomiting (60% vs 25%, 30%), and global QOL impairment (60% vs 30%, 30%) than patients who underwent DG or TG, whose QOL scores were similar. These differences persisted up to 18 months postoperatively. Conclusions: Surgeons should discuss expectations of QOL impairment with their patients before gastrectomy and reassure them that most symptoms resolve by 6 months after operation. Patients who undergo PG suffer from worse QOL impairment than patients who undergo DG or TG. Copyright © 2013 by Lippincott Williams and Wilkins.
Keywords: quality of life; gastric cancer; total gastrectomy; distal gastrectomy; proximal gastrectomy
Journal Title: Annals of Surgery
Volume: 257
Issue: 6
ISSN: 0003-4932
Publisher: Lippincott Williams & Wilkins  
Date Published: 2013-06-01
Start Page: 1039
End Page: 1046
Language: English
DOI: 10.1097/SLA.0b013e31828c4a19
PROVIDER: scopus
PUBMED: 23665970
PMCID: PMC4104506
Notes: --- - "Export Date: 1 July 2013" - "CODEN: ANSUA" - "Source: Scopus"
Citation Impact
MSK Authors
  1. Murray F Brennan
    924 Brennan
  2. Mithat Gonen
    780 Gonen
  3. Vivian Strong
    169 Strong
  4. Daniel Coit
    472 Coit
  5. Dennis Graham
    15 Graham