J Gastric Cancer.  2017 Dec;17(4):342-353. 10.5230/jgc.2017.17.e39.

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

• Lee SS
• Yu W
• Chung HY
• Kwon OK
• Lee WK

• KMID: 2398800
• DOI: http://doi.org/10.5230/jgc.2017.17.e39

Abstract

PURPOSE
This 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 METHODS
This 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.
RESULTS
Multiple 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).
CONCLUSIONS
Long-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.

Keyword

Quality of life; Body composition; Nutritional status; Gastrectomy; Stomach neoplasms

MeSH Terms

Adipose Tissue
Body Composition
Body Water
Constipation
Deglutition Disorders
Dyspnea
Eating
Electric Impedance
Follow-Up Studies
Gastrectomy*
Hematologic Tests
Humans
Mouth
Nutritional Status
Quality of Life*
Retrospective Studies
Stomach Neoplasms
Surveys and Questionnaires
Weights and Measures*

Figure

• 

  Fig. 1 QoL scales with significant differences in metabolic-nutritional changes, exhibiting the nutritional shortcomings of the vulnerable QoL responders to the EORTC QLQ-C30 and QLQ-STO22. QoL = quality of life; EORTC = European Organisation for Research and Treatment of Cancer; QLQ-C30 = Quality of Life Questionnaire-Core 30; QLQ-STO22 = Quality of Life Questionnaire-Stomach. *P<0.05; †P<0.01.

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