Longitudinal Analysis of Quality-of-Life Recovery After Gastrectomy for Cancer
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ORIGINAL ARTICLE –
HEALTH SERVICES RESEARCH AND GLOBAL ONCOLOGY
Longitudinal Analysis of Quality-of-Life Recovery After Gastrectomy for Cancer Yinin Hu, MD1, Elvira L. Vos, MD2, Raymond E. Baser, MS3, Mark A. Schattner, MD4, Makoto Nishimura, MD4, Daniel G. Coit, MD2, and Vivian E. Strong, MD2 1
Division of General and Oncologic Surgery, Department of Surgery, University of Maryland Baltimore, Baltimore, MD; Division of Surgical Oncology, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY; 3 Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY; 4Department of Gastroenterology, Hepatology, and Nutrition, Memorial Sloan-Kettering Cancer Center, New York, NY 2
ABSTRACT Objective. The purpose of this study was to identify factors associated with quality-of-life recovery after gastrectomy. Methods. Patients anticipated to undergo gastric cancer resection were invited to complete the European Organisation for Research and Treatment of Cancer (EORTC) QLQ C30 and STO22 surveys in the preoperative setting and at 0–1.5 months (early), [ 1.5–6 months (intermediate), and [ 6–18 months (late) following resection. Quality-of-life recovery was measured as paired differences between pre- and postoperative results. Multivariable linear regression identified factors associated with preoperative quality of life and degree of change following resection. Results. Across 393 participants, response rates at the intermediate and late postoperative time points were 58% (n = 228) and 71% (n = 277), respectively. Relative to baseline, median global health scale decreased in the early (- 15.1 pts, p \ 0.001) and intermediate (- 3.6 pts, p = 0.02) time points, but recovered by the late time point
This work was presented at the Society for Surgical Oncology Annual Meeting, August 17–18, 2020 (ePoster).
Electronic supplementary material The online version of this article (https://doi.org/10.1245/s10434-020-09274-z) contains supplementary material, which is available to authorized users. Ó Society of Surgical Oncology 2020 First Received: 25 August 2020 Accepted: 3 October 2020 V. E. Strong, MD e-mail: [email protected]
(? 1.2 pts, p = 0.411). Relative to distal/subtotal gastrectomy, proximal/total gastrectomy was associated with worse recovery in both the early and late time points. Surgical complications were associated with worse early recovery. Patients who presented with locally advanced tumors (T3–T4) had lower preoperative quality-of-life scores, and more readily recovered to baseline after surgery. A minimally invasive approach was not associated with postoperative recovery. Conclusions. Most patients recover to baseline within 1 year following major gastrectomy, and recovery is easier with more limited resections. Patients with locally advanced tumors tend to have poorer baseline quality of life, which may improve following resection.
In the US, 27,500 new cases of gastric cancer are diagnosed annually.1 Although a multimodal approach is indicated for all but
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