Ann Surg Treat Res.  2022 Jul;103(1):19-31. 10.4174/astr.2022.103.1.19.

Postoperative quality of life after gastrectomy in gastric cancer patients: a prospective longitudinal observation study

• Wang CJ
• Suh YS
• Lee HJ
• Park JH
• Park SH
• Choi JH
• Alzahrani F
• Alzahrani K
• Kong SH
• Park DJ
• Cao H
• Yang HK

• KMID: 2531144
• DOI: http://doi.org/10.4174/astr.2022.103.1.19

Abstract

Purpose
The European Organization for Research and Treatment of Cancer quality of life (QOL) questionnaires (QLQ-C30, QLQ-OG25, and QLQ-STO22) are widely used for the assessment of gastric cancer patients. This study aimed to use these questionnaires to evaluate QOL in postgastrectomy patients.
Methods
We prospectively evaluated 106 patients with distal gastrectomy (DG), 57 with pylorus-preserving gastrectomy (PPG), and 117 with total gastrectomy (TG). Body weight and QOL questionnaires were evaluated preoperatively and postoperatively (at 3 weeks, and 3, 6, and 12 months).
Results
TG patients had significantly more weight loss than DG/PPG patients. Compared with DG, patients after PPG had less dyspnea (P = 0.008) and trouble with coughing (P = 0.049), but more severe symptoms of insomnia (P = 0.037) and reflux (P = 0.030) at postoperative 12 months. Compared with DG/PPG, TG was associated with worse body image, dysphagia, eating, and taste in both OG25 and STO22. Moreover, OG25 revealed worse QOL in the TG group with respect to odynophagia, eating with others, choked when swallowing, trouble talking, and weight loss. The QOL of patients who received chemotherapy was worse than those in the chemo-free group in both physical functioning and symptoms such as nausea/vomiting, appetite loss, and trouble with taste; however, these side effects would soon disappear after finishing chemotherapy.
Conclusion
PPG was similar to DG in terms of postoperative QOL and maintaining body weight, while TG was always inferior to both DG and PPG. Adjuvant chemotherapy can affect both body weight and QOL despite being reversible.

Keyword

Chemotherapy; European Organization for Research and Treatment of Cancer quality of life; Gastrectomy; Quality of life; Weight loss

Figure

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  Fig. 1 Study participants. DG, distal gastrectomy; PPG, pylorus-preserving gastrectomy; TG, total gastrectomy; QOL, quality of life.

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  Fig. 2 Analysis of body weight loss. (A) Comparison of DGBI (n = 67) and DGBII/DGRY (n = 24). (B) Comparison of DG (n = 91), PPG (n = 56), and TG (n = 88). (C) Comparison of partial gastrectomy (n = 147) and partial gastrectomy with chemotherapy (n = 16). (D) Comparison of TG (n = 88) and TG with chemotherapy (n = 29). DGBI, DG with Billroth-I anastomosis; DGBII/DGRY, DG with Billroth-II/Roux-en-Y anastomosis; DG, distal gastrectomy; PPG, pylorus-preserving gastrectomy; TG, total gastrectomy; Chemo, chemotherapy. *P < 0.05, **P < 0.01.

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  Fig. 3 (A) Radar chart representing mean scores of the EORTC QLQ-C30 global and functional scales among (a) DG, (b) PPG, and (c) TG (higher scores represent better QOL). (B) Radar chart representing mean scores of the EORTC QLQ-C30 symptoms scales among (a) DG, (b) PPG, and (c) TG (lower scores represent better QOL). DG, distal gastrectomy; PPG, pylorus-preserving gastrectomy; TG, total gastrectomy; EORTC QLQ, European Organization for Research and Treatment of Cancer QOL questionnaires; QOL, quality of life.

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  Fig. 4 (A) Radar chart representing mean scores of the EORTC QLQ-OG25 scales among (a) DG, (b) PPG, and (c) TG. (B) Radar chart representing mean scores of the EORTC QLQ-STO22 scales among (a) DG, (b) PPG, and (c) TG. Score of ‘body image’ = 100 – initial score of ‘body image.’ DG, distal gastrectomy; PPG, pylorus-preserving gastrectomy; TG, total gastrectomy; EORTC QLQ, European Organization for Research and Treatment of Cancer quality of life questionnaires.

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