Ann Surg Treat Res.  2020 May;98(5):262-269. 10.4174/astr.2020.98.5.262.

Chronological changes in quality of life and body composition after gastrectomy for locally advanced gastric cancer

Affiliations
  • 1Gastric Cancer Center, Kyungpook National University Chilgok Hospital, Daegu, Korea
  • 2Department of Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
  • 3Department of Surgery, Kyungpook National University Hospital, Daegu, Korea

Abstract

Purpose
We evaluated the changes in body composition (BC) and quality of life (QoL) in patients who underwent gastrectomy for advanced gastric cancer.
Methods
BC data using segmental multifrequency bioelectrical impedance analysis and QoL data from the EORTC (European Organisation for the Research and Treatment of Cancer) gathered via QLQ-C30 and QLQ-STO22 questionnaires were obtained from 300 patients preoperatively and at 1, 2, and 3 years after surgery. In total, 114 patients underwent total gastrectomy (TG group) and 186 underwent distal gastrectomy (DG group).
Results
According to BC analysis, at 3 years postoperatively, the average body weight (P = 0.002), protein mass (P = 0.028), body fat mass (P = 0.009), skeletal muscle mass (P = 0.037), and visceral fat area (P = 0.012) was significantly decreased in the TG group than in the DG group compared to the preoperative. In the QLQ-C30, physical functioning (P = 0.001), role functioning (P = 0.013), and fatigue (P = 0.005) showed significantly worse QoL in the TG group than in the DG group at 2 and 3 years postoperatively. In the QLQ-STO22, pain (P = 0.001), reflux symptoms (P = 0.009), eating restrictions (P = 0.001), anxiety (P = 0.008), taste (P = 0.011), and body image (P = 0.014) showed greater continuous deterioration postoperatively in the TG group than in the DG group.
Conclusion
Persistent deterioration of BC and QoL is a serious concern following total gastrectomy. Long-term management of BC is required after gastrectomy and efforts should be made to improve the QoL in patients as soon as possible, postoperatively.

Keyword

Body composition; Gastrectomy; Quality of life; Stomach neoplasms

Figure

  • Fig. 1 Chronological changes in body composition. TG, total gastrectomy; DG, distal gastrectomy. *Significant changes between the groups and over time.

  • Fig. 2 Chronological changes in quality of life (global health status and functional scales of EORTC QLQ-C30). EORTC, European Organisation for the Research and Treatment of Cancer; GH, global health status; PF2, physical functioning; RF2, role functioning; EF, emotional functioning; CF, cognitive functioning; SF, social functioning. *Significant changes between the groups and over time.

  • Fig. 3 Chronological changes in quality of life (symptom scales and items of EORTC QLQ-C30). EORTC, European Organisation for the Research and Treatment of Cancer; FA, fatigue; NV, nausea and vomiting; PA, pain; DY, dyspnea; SL, insomnia; AP, appetite loss; CO, constipation; DI, diarrhea; FI, financial difficulties; TG, total gastrectomy; DG, distal gastrectomy. *Significant changes between the groups and over time.

  • Fig. 4 Chronological changes in quality of life (EORTC QLQ-STO22). EORTC, European Organisation for the Research and Treatment of Cancer; XDG, dysphagia; Xpain, pain; XRflx, reflux symptoms; XEatR, eating restrictions; Anx, anxiety; DM, having a dry mouth; T, taste; BI, body image; HL, hair loss. *Significant changes between the groups and over time.


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