Climent M, Munarriz M, Blazeby J M, Dorcaratto D, Ramón J M, Carrera M J, Fontane L, Grande L, Pera M
Section of Gastrointestinal Surgery, Hospital Universitari del Mar, IMIM (Hospital del Mar Medical Research Institute), Universitat Autònoma de Barcelona, Barcelona, Spain.
School of Social and Community Medicine, University of Bristol, and University Hospital Bristol National Health Services Foundation Trust, Bristol, UK.
Eur J Surg Oncol. 2017 Jul;43(7):1337-1343. doi: 10.1016/j.ejso.2017.01.239. Epub 2017 Feb 9.
Malnutrition is common in patients undergoing gastric cancer resection, leading to weight loss, although little is known about how this impacts on health-related quality of life (HRQL). This study aimed to explore the association between HRQL and weight loss in patients 2 years after curative gastric cancer resection.
Consecutive patients undergoing curative gastric cancer resection and surviving at least 2 years without disease recurrence were recruited. Patients completed the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the specific module for gastric cancer (STO22) before and 2 years postoperatively and associations between HRQL scores and patients with and without ≥ 10% body weight loss (BWL) were examined.
A total of 76 patients were included, of whom 51 (67%) had BWL ≥10%. At 2 years postoperatively, BWL ≥10% was associated with deterioration of all functional aspects of quality of life, with persistent pain (21.6%), diarrhoea (13.7%) and nausea/vomiting (13.7%). By contrast, none of the patients with BWL <10% experienced severe nausea/vomiting, pain or diarrhoea.
Disabling symptoms occurred more frequently in patients with ≥10% BWL than in those with <10% BWL, with a relevant negative impact on HRQL. A cause-effect relationship between weight loss and postoperative outcome remains unsolved.
营养不良在接受胃癌切除术的患者中很常见，会导致体重减轻，尽管对于这如何影响健康相关生活质量（HRQL）知之甚少。本研究旨在探讨根治性胃癌切除术后2年患者的HRQL与体重减轻之间的关联。
招募接受根治性胃癌切除术且存活至少2年无疾病复发的连续患者。患者在术前和术后2年完成欧洲癌症研究与治疗组织生活质量问卷（EORTC QLQ-C30）以及胃癌特异性模块（STO22），并检查HRQL评分与体重减轻≥10%（BWL）和未体重减轻≥10%的患者之间的关联。
共纳入76例患者，其中51例（67%）体重减轻≥10%。术后2年时，体重减轻≥10%与生活质量所有功能方面的恶化相关，包括持续性疼痛（21.6%）、腹泻（13.7%）和恶心/呕吐（13.7%）。相比之下，体重减轻<10%的患者均未出现严重的恶心/呕吐、疼痛或腹泻。
体重减轻≥10%的患者比体重减轻<10%的患者更频繁出现致残症状，对HRQL有显著负面影响。体重减轻与术后结局之间的因果关系仍未解决。
