Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China.
National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Eur J Cancer Care (Engl). 2020 Nov;29(6):e13283. doi: 10.1111/ecc.13283. Epub 2020 Jun 29.
To evaluate the health-related quality of life (HRQoL) and health state utility scores of gastric cancer patients in daily life at different clinical stages after treatment, and to explore influencing factors associated with HRQoL.
Gastric cancer patients discharged from hospitals and healthy controls identified by screening were recruited. The three-level EQ-5D was employed to assess HRQoL and was scored using two Chinese-specific tariffs published in 2014 and 2018.
A total of 1,399 patients and 2,179 healthy controls were recruited. The likelihood of reporting problems in the five dimensions for patients was 4.0-23.8 times higher than controls. Based on the 2014/2018 tariff, the mean EQ-5D utility score was 0.321/0.163 lower than controls, and the mean utility scores of each patient subgroup were 0.077/0.039 (high-grade intraepithelial neoplasia/carcinoma in situ), 0.254/0.121 (Stage I), 0.249/0.123 (Stage II), 0.353/0.182 (Stage III) and 0.591/0.309 (Stage IV) lower than controls (all statistically significant). Age, occupation, duration of illness, other chronic disease status and therapeutic regimen had a significant impact upon different aspects of HRQoL in patients.
Gastric cancer significantly impaired patients' HRQoL in daily life after treatment. More advanced cancer stages were associated with larger decrements on health state utility.
评估治疗后不同临床阶段胃癌患者日常生活中的健康相关生活质量（HRQoL）和健康状态效用评分，并探讨与 HRQoL 相关的影响因素。
通过筛选，招募出院的胃癌患者和健康对照者。采用三级 EQ-5D 评估 HRQoL，并使用 2014 年和 2018 年发布的两种中国特定关税进行评分。
共招募了 1399 名患者和 2179 名健康对照者。患者五个维度报告问题的可能性是对照组的 4.0-23.8 倍。根据 2014/2018 关税，EQ-5D 效用评分平均比对照组低 0.321/0.163，每个患者亚组的平均效用评分分别为 0.077/0.039（高级上皮内瘤变/原位癌）、0.254/0.121（I 期）、0.249/0.123（II 期）、0.353/0.182（III 期）和 0.591/0.309（IV 期），均低于对照组（均有统计学意义）。年龄、职业、患病时间、其他慢性病状况和治疗方案对患者的不同方面的 HRQoL 有显著影响。
胃癌治疗后显著降低了患者日常生活中的 HRQoL。癌症分期越晚，健康状态效用的下降幅度越大。
