Department of Surgery, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu 700-721, Republic of Korea.
Department of Surgery, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu 700-721, Republic of Korea.
Int J Surg. 2014;12(7):700-5. doi: 10.1016/j.ijsu.2014.05.067. Epub 2014 May 24.
This study investigated how total gastrectomy (TG), along with memories of cancer, affect the subjective wellness of survivors long after surgery. Rational approaches for effectively improving the quality of life (QoL) of these survivors were suggested.
Between 2008 and 2013, QoL data of gastric cancer patients who underwent a curative TG, were obtained at 5-year postoperative follow-up visits (5-year survivors) and at visits beyond 5 years (long-term survivors). The control groups for these survivor groups were constructed from volunteers who visited our health-examination center for annual medical checkups. The Korean versions of the European Organization for Research and Treatment (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) and the gastric cancer specific module, the EORTC QLQ-STO22, were used to assess QoL.
Five-year survivors showed worse QoL compared to the control group in role functioning, social functioning, nausea/vomiting, appetite loss, financial difficulties, reflux, eating restrictions, taste, and body image, and better QoL in the emotional and cognitive functioning scales. In long-term survivors, deterioration in QoL were still apparent in financial difficulties, reflux, and eating restrictions, while QoL differences in the remaining scales had diminished.
Surviving 5 years after TG does not result in living in a carefree state in terms of QoL. After 5 postoperative years, survivors still need extended care for deteriorated QoL indicators due to symptomatic, behavioral, and financial consequences of surgery.
While relevant clinical and institutional approaches are required for corresponding declines in QoL, such efforts must extend beyond 5 postoperative years.
本研究调查了全胃切除术(TG)和癌症记忆如何影响术后多年的幸存者的主观健康状况。提出了合理的方法来有效提高这些幸存者的生活质量(QoL)。
在 2008 年至 2013 年间,对接受根治性 TG 的胃癌患者的 QoL 数据进行了调查,这些患者在术后 5 年随访(5 年幸存者)和超过 5 年的随访时(长期幸存者)。这些幸存者组的对照组是由参加我们健康检查中心年度体检的志愿者组成的。使用欧洲癌症研究与治疗组织(EORTC)生活质量问卷核心 30 版(QLQ-C30)和胃癌特定模块 EORTC QLQ-STO22 的韩文版评估 QoL。
与对照组相比,5 年幸存者在角色功能、社会功能、恶心/呕吐、食欲减退、经济困难、反流、饮食限制、味觉和身体形象方面的 QoL 更差,在情感和认知功能方面的 QoL 更好。在长期幸存者中,经济困难、反流和饮食限制方面的 QoL 仍在恶化,而其余量表的 QoL 差异已缩小。
在 TG 后存活 5 年并不能保证 QoL 无忧无虑。术后 5 年后,由于手术的症状、行为和经济后果,幸存者仍然需要对 QoL 恶化的指标进行扩展护理。
虽然需要采取相关的临床和机构方法来对应 QoL 的下降,但这些努力必须超过术后 5 年。