Prospective Multicenter Observational Study on Postoperative Quality of Life According to Type of Gastrectomy for Gastric Cancer.
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Oh Sung Eun, Suh Yun-Suhk, An Ji Yeong, Ryu Keun Won, Cho In, Kim Sung Geun, Park Ji-Ho, Hur Hoon, Kim Hyung-Ho, Ahn Sang-Hoon, Hwang Sun-Hwi, Yoon Hong Man, Park Ki Bum, Kim Hyoung-Il, Kwon In Gyu, Yang Han-Kwang, Suh Byoung-Jo, Jeong Sang-Ho, Kim Tae-Han, Kwon Oh Kyoung, Ahn Hye Seong, Park Ji Yeon, Yoon Ki Young, Son Myoung Won, Kong Seong-Ho, Son Young-Gil, Song Geum Jong, Yun Jong Hyuk, Bae Jung-Min, Park Do Joong, Lee Sol, Yang Jun-Young, Seo Kyung Won, Jang You-Jin, Kang So Hyun, Eom Bang Wool, Lee Joongyub, Lee Hyuk-Joon, Korean Quality of Life in Stomach Cancer Patients Study (KOQUSS) Group
Аннотация
MATERIALS AND METHODS: A multicenter prospective observational study was conducted in Korea using the Korean Quality of Life in Stomach Cancer Patients Study (KOQUSS)-40, a new QoL assessment tool focusing on postgastrectomy syndrome. Overall, 496 patients with gastric cancer were enrolled, and QoL was assessed at 5 time points: preoperatively and at 1, 3, 6, and 12 months after surgery.
RESULTS: Distal gastrectomy (DG) and pylorus-preserving gastrectomy (PPG) showed significantly better outcomes than total gastrectomy (TG) and proximal gastrectomy (PG) with regard to total score, indigestion, and dysphagia. DG, PPG, and TG also showed significantly better outcomes than PG in terms of dumping syndrome and worry about cancer. Postoperative QoL did not differ significantly according to anastomosis type in DG, except for Billroth I anastomosis, which achieved better bowel habit change scores than the others. No domains differed significantly when comparing double tract reconstruction and esophagogastrostomy after PG. The total QoL score correlated significantly with postoperative body weight loss (more than 10%) and extent of resection (P<0.05 for both). Reflux as assessed by KOQUSS-40 did not correlate significantly with reflux observed on gastroscopy 1 year postoperatively (P=0.064).
CONCLUSIONS: Our prospective observation using KOQUSS-40 revealed that DG and PPG lead to better QoL than TG and PG. Further study is needed to compare postoperative QoL according to anastomosis type in DG and PG.