Observational Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 28, 2021; 27(16): 1816-1827
Published online Apr 28, 2021. doi: 10.3748/wjg.v27.i16.1816
Health-related quality of life after curative resection for gastric adenocarcinoma
Jan Grosek, Hana Zavrtanik, Aleš Tomažič
Jan Grosek, Hana Zavrtanik, Aleš Tomažič, Department of Abdominal Surgery, University Medical Centre Ljubljana, Ljubljana 1000, Slovenia
Jan Grosek, Aleš Tomažič, Medical Faculty, University of Ljubljana, Ljubljana 1000, Slovenia
Author contributions: Grosek J and Tomažič A made substantial contributions to the conception and design of the study; Zavrtanik H contributed to the acquisition, analysis and interpretation of the data; all authors participated in drafting the manuscript; Grosek J and Tomažič A revised it critically; all authors read and approved the final version of the manuscript.
Institutional review board statement: The study was approved by the National Medical Ethics Committee of Republic of Slovenia (approval No. 0120-315/2019/3).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no financial or non- financial competing interests.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Aleš Tomažič, MD, PhD, Chief Doctor, Professor, Surgeon, Department of Abdominal Surgery, University Medical Centre Ljubljana, Zaloška cesta 7, Ljubljana 1000, Slovenia. ales.tomazic@kclj.si
Received: January 31, 2021
Peer-review started: January 31, 2021
First decision: February 22, 2021
Revised: March 5, 2021
Accepted: April 13, 2021
Article in press: April 13, 2021
Published online: April 28, 2021
Processing time: 79 Days and 16.8 Hours
Abstract
BACKGROUND

With improved survival in gastric cancer patients, health-related quality of life has become an important clinical endpoint alongside primary oncological outcomes.

AIM

To investigate health-related quality of life after various surgical procedures for gastric cancer treatment.

METHODS

The validated Slovenian version of the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (QLQ-C30) and its gastric cancer-specific module (QLQ STO-22) was sent for self-completion to patients that underwent curative resection for gastric adenocarcinoma between January 2014 and December 2018 at our centre. In total, 116 patients responded. Scores were compared between patients after subtotal distal vs total gastrectomy and patients after subtotal distal gastrectomy with Billroth II vs Roux-en-Y reconstruction.

RESULTS

Interestingly, the extent of resection did not influence daily functioning; however, more dysphagia and eating restrictions were reported in patients after total gastrectomy when compared to patients after subtotal distal gastrectomy. Moreover, patients with Billroth II reconstruction after subtotal distal resection experienced worse physical and role functioning and reported more pain, fatigue and reflux compared to Roux-en-Y reconstruction.

CONCLUSION

Based on our results, Roux-en-Y reconstruction after subtotal distal gastrectomy should be preferred over Billroth II reconstruction. The data obtained from this study will help surgeons when preoperatively informing their patients about expected functional outcomes after gastrectomy and enable them to ensure proper supportive care of their patients in the postoperative period.

Keywords: Gastric cancer; Quality of life; Roux-en-Y; Billroth II; Gastrectomy

Core Tip: Quality of life assessment is an important tool to guide and evaluate treatment interventions, especially after a major surgery like gastrectomy. We conducted a cross-sectional survey among patients with gastric adenocarcinoma treated at our centre to provide insight into overall wellbeing after curative resection. The information provided will guide surgeons in selecting an optimal treatment approach and informing patients about expected treatment outcomes.