Document Detail


Quality of life after gastrectomy for adenocarcinoma: a prospective cohort study.
MedLine Citation:
PMID:  23665970     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Paul J Karanicolas; Dennis Graham; Mithat Gönen; Vivian E Strong; Murray F Brennan; Daniel G Coit
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of surgery     Volume:  257     ISSN:  1528-1140     ISO Abbreviation:  Ann. Surg.     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-05-13     Completed Date:  2013-08-01     Revised Date:  2014-07-31    
Medline Journal Info:
Nlm Unique ID:  0372354     Medline TA:  Ann Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1039-46     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / pathology,  surgery*
Age Factors
Aged
Female
Gastrectomy*
Humans
Linear Models
Male
Middle Aged
Neoadjuvant Therapy
Neoplasm Staging
Prospective Studies
Quality of Life*
Questionnaires
Stomach Neoplasms / pathology,  surgery*
Treatment Outcome
Grant Support
ID/Acronym/Agency:
P30 CA008748/CA/NCI NIH HHS
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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