Wang Chao-Jie, Suh Yun-Suhk, Lee Hyuk-Joon, Park Ji-Hyeon, Park Shin-Hoo, Choi Jong-Ho, Alzahrani Fadhel, Alzahrani Khalid, Kong Seong-Ho, Park Do-Joong, Cao Hui, Yang Han-Kwang
Department of Surgery, Seoul National University Hospital, Seoul, Korea.
Department of Gastrointestinal Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Ann Surg Treat Res. 2022 Jul;103(1):19-31. doi: 10.4174/astr.2022.103.1.19. Epub 2022 Jul 7.
The European Organization for Research and Treatment of Cancer quality of life (QOL) questionnaires (QLQ-C30, QLQ-OG25, and QLQ-STO22) are widely used for the assessment of gastric cancer patients. This study aimed to use these questionnaires to evaluate QOL in postgastrectomy patients.
We prospectively evaluated 106 patients with distal gastrectomy (DG), 57 with pylorus-preserving gastrectomy (PPG), and 117 with total gastrectomy (TG). Body weight and QOL questionnaires were evaluated preoperatively and postoperatively (at 3 weeks, and 3, 6, and 12 months).
TG patients had significantly more weight loss than DG/PPG patients. Compared with DG, patients after PPG had less dyspnea (P = 0.008) and trouble with coughing (P = 0.049), but more severe symptoms of insomnia (P = 0.037) and reflux (P = 0.030) at postoperative 12 months. Compared with DG/PPG, TG was associated with worse body image, dysphagia, eating, and taste in both OG25 and STO22. Moreover, OG25 revealed worse QOL in the TG group with respect to odynophagia, eating with others, choked when swallowing, trouble talking, and weight loss. The QOL of patients who received chemotherapy was worse than those in the chemo-free group in both physical functioning and symptoms such as nausea/vomiting, appetite loss, and trouble with taste; however, these side effects would soon disappear after finishing chemotherapy.
PPG was similar to DG in terms of postoperative QOL and maintaining body weight, while TG was always inferior to both DG and PPG. Adjuvant chemotherapy can affect both body weight and QOL despite being reversible.
欧洲癌症研究与治疗组织生活质量（QOL）问卷（QLQ - C30、QLQ - OG25和QLQ - STO22）被广泛用于评估胃癌患者。本研究旨在使用这些问卷评估胃切除术后患者的生活质量。
我们前瞻性评估了106例行远端胃切除术（DG）的患者、57例行保留幽门胃切除术（PPG）的患者和117例行全胃切除术（TG）的患者。术前及术后（3周、3个月、6个月和12个月）评估体重和生活质量问卷。
TG患者体重减轻明显多于DG/PPG患者。与DG相比，PPG术后12个月患者呼吸困难（P = 0.008）和咳嗽问题（P = 0.049）较少，但失眠（P = 0.037）和反流（P = 0.030）症状更严重。与DG/PPG相比，TG在OG25和STO22中均与更差的身体形象、吞咽困难、进食和味觉相关。此外，OG25显示TG组在吞咽痛、与他人一起进食、吞咽时噎住、说话困难和体重减轻方面生活质量更差。接受化疗患者的生活质量在身体功能以及恶心/呕吐、食欲减退和味觉问题等症状方面比未化疗组更差；然而，这些副作用在化疗结束后很快就会消失。
PPG在术后生活质量和维持体重方面与DG相似，而TG始终劣于DG和PPG。辅助化疗尽管是可逆的，但会影响体重和生活质量。
