Department of Surgery, University of Calgary, AB, Canada.
J Surg Oncol. 2012 Mar 15;105(4):337-41. doi: 10.1002/jso.22139. Epub 2011 Nov 17.
Few studies describe quality of life (QoL) outcomes following gastrectomy for gastric cancer using a validated instrument. The gastric cancer module for the Functional Assessment of Cancer Therapy system of QoL measurement tools (FACT-Ga) was utilized to determine the changes in QoL following gastrectomy, and during the disease course.
In 43 patients undergoing gastrectomy for gastric cancer, outcome such as complications, recurrence, and survival were annotated. Karnofsky performance status (KPS) and QoL were determined preoperatively and at each follow-up visit.
Nineteen (44%) patients and 24 (56%) patients underwent partial gastrectomy (PG) and total gastrectomy (TG), respectively. Complications occurred in 30%, and one mortality (2.3%) occurred. Median survival was 23 months. KPS, FACT-G, and FACT-Ga scores all decreased after surgery, and normalized by 6 months. There was no significant difference in QoL in patients who had a PG or TG, although the type of gastrectomy did affect KPS. QoL dropped on average 4.4 ± 3.6 months prior to death.
Surgery adversely affects QoL for up to 6 months. Thereafter, QoL mirrors changes in disease status. More studies are required to document the QoL cost-benefit ratio in gastric cancer, which often is accompanied by short survival benefits.
很少有研究使用经过验证的工具描述胃癌胃切除术后的生活质量（QoL）结果。利用癌症治疗功能评估系统的胃癌模块（FACT-Ga）来确定胃切除术后以及疾病过程中 QoL 的变化。
在 43 名接受胃癌胃切除术的患者中，记录了并发症、复发和生存等结果。术前和每次随访时都确定了 Karnofsky 表现状态（KPS）和 QoL。
19 名（44%）患者和 24 名（56%）患者分别接受了部分胃切除术（PG）和全胃切除术（TG）。并发症发生率为 30%，死亡率为 2.3%。中位生存期为 23 个月。手术后 KPS、FACT-G 和 FACT-Ga 评分均下降，6 个月后恢复正常。PG 或 TG 患者的 QoL 没有显著差异，尽管胃切除术的类型确实会影响 KPS。QoL 在死亡前平均下降 4.4±3.6 个月。
手术会对 QoL 产生长达 6 个月的不利影响。此后，QoL 反映了疾病状况的变化。需要更多的研究来记录胃癌 QoL 的成本效益比，因为胃癌通常伴随着短暂的生存获益。
