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集中式胃癌手术对巴西健康相关生活质量的影响。

Influence of the centralizing gastric cancer surgery on the health-related quality of life in Brazil.

作者信息

Pinheiro Rodrigo Nascimento, Mucci Samantha, Zanatto Renato Morato, Picanço Junior Olavo Magalhães, Bottino Augusto Angelo Granado, Fontoura Renata Pereira, Lopes Filho Gaspar de Jesus

机构信息

Interdisciplinary Surgical Science Postgraduate Program, Paulista School of Medicine, Federal University of São Paulo, São Paulo, Brazil.

Surgical Oncology, Base Hospital of the Federal District, Brasília, Federal District, Brazil.

出版信息

J Gastrointest Oncol. 2023 Jun 30;14(3):1235-1249. doi: 10.21037/jgo-22-1114. Epub 2023 Jun 27.

Abstract

BACKGROUND

The assessment of health-related quality of life (QoL) has improved the treatment of gastric cancer. Aiming to compare the influence of skilled surgeons in general hospitals versus specialized hospitals in cancer in Brazil, this study evaluated the relationship between quality of life and types of hospitals (general or cancer) in treating patients with gastric adenocarcinoma operated by surgeons with specific training in Surgical Oncology.

METHODS

This was a cross-sectional study involving 104 patients. Inferential analyses were used to compare two Brazilian general hospitals and a cancer center, evaluating scores of the SF-36 and FACT-Ga QoL questionnaires (Kruskal-Wallis test, Mann-Whitney test); gender, smoking, and tests status (Pearson's Chi-Square test); ethnicity, alcoholism, location of the tumor in the stomach, Lauren's histological types, and type of surgery (Fisher's exact test), number of lymph nodes resected by Surgical Oncologists [Analysis of Variance (ANOVA) with a Fixed Factor], and comparative survival analysis (Log-Rank test).

RESULTS

Patients treated at a cancer hospital had higher scores of the FACT-Ga (FACT-G total score, P=0.023; physical well-being, PWB, P=0.006; and functional well-being, FWB, P=0.011). The mean scores of the SF-36 questionnaire showed similar behavior but without reaching a significant difference. Patients operated by Surgical Oncologists at the cancer hospital had better scores in emotional well-being FACT-Ga domain (EWB, P=0.034 and P=0.047) compared to those operated by Surgical Oncologists in general hospitals. There was no significant difference in survival among the three hospitals (P=0.214).

CONCLUSIONS

In this study, it was possible to suggest the relationship between QoL assessment scores with the centralization of care at specialized cancer hospital in the treatment of patients with gastric adenocarcinoma undergoing surgery with curative intent in Brazil.

摘要

背景

健康相关生活质量(QoL)评估改善了胃癌的治疗。为比较巴西综合医院与癌症专科医院中技术娴熟的外科医生的影响,本研究评估了生活质量与医院类型(综合或癌症)在治疗接受过外科肿瘤学专门培训的外科医生手术的胃腺癌患者中的关系。

方法

这是一项横断面研究,涉及104名患者。采用推断性分析比较两家巴西综合医院和一家癌症中心,评估SF - 36和FACT - Ga生活质量问卷得分(Kruskal - Wallis检验、Mann - Whitney检验);性别、吸烟和检测状态(Pearson卡方检验);种族、酗酒、肿瘤在胃中的位置、劳伦组织学类型和手术类型(Fisher精确检验)、外科肿瘤学家切除的淋巴结数量[固定因素方差分析(ANOVA)]以及比较生存分析(对数秩检验)。

结果

在癌症医院接受治疗的患者FACT - Ga得分更高(FACT - G总分,P = 0.023;身体健康,PWB,P = 0.006;功能健康,FWB,P = 0.011)。SF - 36问卷的平均得分显示出类似趋势,但未达到显著差异。与综合医院的外科肿瘤学家手术的患者相比,癌症医院的外科肿瘤学家手术的患者在FACT - Ga情感健康领域(EWB,P = 0.034和P = 0.047)得分更高。三家医院之间的生存率无显著差异(P = 0.214)。

结论

在本研究中,可以表明在巴西,对于接受根治性手术的胃腺癌患者,生活质量评估得分与在专门癌症医院集中治疗之间存在关联。

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