Kinami Shinichi, Nakamura Naohiko, Zhiyong Jiang, Miyata Takashi, Fujita Hideto, Takamura Hiroyuki, Ueda Nobuhiko, Iida Yasuo, Kosaka Takeo
Department of Surgical Oncology, Kanazawa Medical University, Kahoku, Ishikawa 920-0293, Japan.
Department of Mathematics, Division of General Education, Kanazawa Medical University, Kahoku, Ishikawa 920-0293, Japan.
Mol Clin Oncol. 2020 Aug;13(2):133-140. doi: 10.3892/mco.2020.2061. Epub 2020 Jun 3.
It has previously been suggested that postgastrectomy syndrome (PGS) is more severe in patients after surgery for advanced gastric cancer than in patients with early gastric cancer. Using the postgastrectomy syndrome assessment scale-45 (PGSAS-45), the present study aimed to determine whether PGS for postgastrectomy patients, in Kanazawa Medical University Hospital, with advanced gastric cancer was more severe than for patients with early gastric cancer. A questionnaire survey was conducted using PGSAS-45 for curative gastric cancer gastrectomy cases at Kanazawa Medical University Hospital. The questionnaire data were combined with patient background data, anonymized and moved to an unlinked file for patient privacy. Using this dataset, non-recurrent cases of distal partial gastrectomy were extracted and divided into two groups, stage IA or IB patients (group E), and stage IIA or higher (group A). The main outcome measures (MOMs) of PGSAS-45 were compared between the two groups. The participants in the present study included 35 cases in group E and 22 cases in group A. The results of a univariate analysis to compare the MOMs between the two groups showed that only the dumping subscale was significantly different in group A and was judged to be caused by the underlying bias of the background factor. There were no MOMs with significant differences in the pathological stage based on multiple regression analyses. In cases of distal partial gastrectomy, the PGS and quality of life (QoL) of patients following advanced gastric cancer surgery were similar to those of patients with early gastric cancer. The standardized treatment for advanced gastric cancer did not induce notable postoperative failures, and QoL was not impaired. In contrast, for early-stage gastric cancer cases, the present study suggests that it is necessary to distinguish metastasis-negative cases to indicate an appropriate, function-preserving curative gastrectomy.
先前有研究表明，进展期胃癌患者术后的胃切除术后综合征（PGS）比早期胃癌患者更为严重。本研究使用胃切除术后综合征评估量表-45（PGSAS-45），旨在确定金泽医科大学医院中进展期胃癌胃切除术后患者的PGS是否比早期胃癌患者更为严重。对金泽医科大学医院行根治性胃癌胃切除术的病例使用PGSAS-45进行问卷调查。问卷数据与患者背景数据相结合，匿名处理后转移至独立文件以保护患者隐私。利用该数据集，提取远端部分胃切除术的非复发病例并分为两组，IA期或IB期患者（E组）和IIA期及以上患者（A组）。比较两组之间PGSAS-45的主要结局指标（MOMs）。本研究的参与者包括E组35例和A组22例。两组之间比较MOMs的单因素分析结果显示，只有倾倒分量表在A组中有显著差异，且被判定是由背景因素的潜在偏倚导致的。基于多元回归分析，病理分期方面没有MOMs存在显著差异。在远端部分胃切除术病例中，进展期胃癌手术后患者的PGS和生活质量（QoL）与早期胃癌患者相似。进展期胃癌的标准化治疗未引起明显的术后不良情况，且QoL未受损害。相比之下，对于早期胃癌病例，本研究表明有必要区分无转移病例，以指导进行合适的、保留功能的根治性胃切除术。
