1
|
Vallance PC, Mack L, Bouchard-Fortier A, Jost E. Quality of Life Following the Surgical Management of Gastric Cancer Using Patient-Reported Outcomes: A Systematic Review. Curr Oncol 2024; 31:872-884. [PMID: 38392059 PMCID: PMC10888285 DOI: 10.3390/curroncol31020065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/30/2024] [Accepted: 01/30/2024] [Indexed: 02/24/2024] Open
Abstract
Introduction: Surgical management of gastric adenocarcinoma can have a drastic impact on a patient's quality of life (QoL). There is high variability among surgeons' preferences for the type of resection and reconstructive method. Peri-operative and cancer-specific outcomes remain equivalent between the different approaches. Therefore, postoperative quality of life can be viewed as a deciding factor for the surgical approach. The goal of this study was to interrogate patient QoL using patient-reported outcomes (PROs) following gastrectomy for gastric cancer. Methods: This systematic review was registered at Prospero and followed PRISMA guidelines. Medline, Embase, and Scopus were used to perform a literature search on 18 January 2020. A set of selection criteria and the data extraction sheet were predefined. Covidence (Melbourne, Australia) software was used; two reviewers (P.C.V. and E.J.) independently reviewed the articles, and a third resolved conflicts (A.B.F.). Results: The search yielded 1446 studies; 308 articles underwent full-text review. Ultimately, 28 studies were included for qualitative analysis, including 4630 patients. Significant heterogeneity existed between the studies. Geography was predominately East Asian (22/28 articles). While all aspects of quality of life were found to be affected by a gastrectomy, most functional or symptom-specific measures reached baseline by 6-12 months. The most significant ongoing symptoms were reflux, diarrhoea, and nausea/vomiting. Discussion: Generally, patients who undergo a gastrectomy return to baseline QoL by one year, regardless of the type of surgery or reconstruction. A subtotal distal gastrectomy is preferred when proper oncologic margins can be obtained. Additionally, no one form of reconstruction following gastrectomy is statistically preferred over another. However, for subtotal distal gastrectomy, there was a trend toward Roux-en-Y reconstruction as superior to abating reflux.
Collapse
Affiliation(s)
| | - Lloyd Mack
- Department of Surgery, University of Calgary, Calgary, AB T2N 1N4, Canada (A.B.-F.)
- Department of Oncology, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Antoine Bouchard-Fortier
- Department of Surgery, University of Calgary, Calgary, AB T2N 1N4, Canada (A.B.-F.)
- Department of Oncology, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Evan Jost
- Department of Surgery, University of Calgary, Calgary, AB T2N 1N4, Canada (A.B.-F.)
- Department of Oncology, University of Calgary, Calgary, AB T2N 1N4, Canada
| |
Collapse
|
2
|
Yılmaz M, Erdiş E, Uçar M, Yücel B. "Evaluation of quality of life in patients with gastric adenocarcinoma receiving chemoradiotherapy: a cross-sectional study". Support Care Cancer 2023; 31:600. [PMID: 37770678 DOI: 10.1007/s00520-023-08036-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 09/02/2023] [Indexed: 09/30/2023]
Abstract
PURPOSE The aim of this study was to evaluate quality of life (QoL) in patients with gastric adenocarcinoma receiving adjuvant chemoradiotherapy (CRT). METHODS The European Organization for Cancer Research and Treatment Quality of Life Questionnaire-Core 30 (QLQ-C30) and site-specific module for gastric cancer (QLQ-STO22) were administered at four time points to 156 patients admitted to Cumhuriyet University Oncology Center between 2011 and 2018. RESULTS The patient group comprised 76% men and 24% women with a median age of 61 years (range, 18-88). During CRT, 12 patients (8%) discontinued treatment, 25 (16%) lost weight, and 42 (27%) had reduced performance. There was significant worsening in QLQ-C30 global health status and all functional and symptom scale scores at CRT completion. These changes were also clinically significant except for physical functioning scores and were supported by minimal clinically important difference measurements. In the QLQ-STO22, all symptoms except dry mouth and hair loss were negatively affected at CRT completion. In general, scores were improved at 1 month after CRT and almost all scores reached baseline level by 6 months. Certain scores were more adversely affected in women (global health status, physical functioning, role functioning, fatigue, pain, and insomnia), those who lost weight during CRT (emotional functioning), and those with CRT interruption (emotional functioning and anxiety). CONCLUSION Although CRT reduces QoL in patients with gastric cancer, the effects tend to resolve within 6 months after completing treatment. Female sex, weight loss, and CRT interruption negatively affected some QoL scores.
Collapse
Affiliation(s)
- Mukaddes Yılmaz
- Department of Medical Oncology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey.
| | - Eda Erdiş
- Department of Radiation Oncology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Mahmut Uçar
- Department of Medical Oncology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Birsen Yücel
- Department of Radiation Oncology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| |
Collapse
|
3
|
Kim SH, Choe YH, Choi J, Park JY, Yi E. Factors Associated With Quality of Life Among Posttreatment Cancer Survivors in Korea: A Meta-analysis. Cancer Nurs 2023:00002820-990000000-00162. [PMID: 37523733 DOI: 10.1097/ncc.0000000000001273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
BACKGROUND Identification of factors associated with quality of life (QOL) among cancer survivors is crucial for identifying potential targets for intervention. OBJECTIVES We aimed to provide evidence of factors associated with the QOL among posttreatment cancer survivors in Korea. METHODS We performed a systematic literature search from January 2000 to September 2022 using PubMed, EMBASE, CINAHL, PsycINFO, and Korean databases (RISS, SCIENCEON). We evaluated study quality using the Joanna Briggs Institute Quality Appraisal Checklists for Analytical Cross-sectional Studies and performed statistical analysis using the R 3.0 software (R Foundation for Statistical Computing, Vienna, Austria) package. We analyzed the pooled effect sizes of potential QOL correlates by the random-effects model. RESULTS This meta-analysis included 31 studies with 8934 participants. The pooled estimates were significantly large for economic status (r = -0.53); significantly medium for fatigue (r = -0.39), anxiety (r = -0.29), depression (r = -0.42), self-efficacy (r = 0.37), and social support (r = 0.30); and significantly small for education level (r = -0.18), job status (r = -0.09), cancer stage (r = -0.20), and time since diagnosis (r = -0.26). CONCLUSIONS Low education level, having no job, low economic status, advanced cancer stage, short disease period, fatigue, anxiety, and depression were significantly associated with worse QOL, whereas self-efficacy and social support were significantly associated with better QOL. IMPLICATIONS FOR PRACTICE The findings have potential implications for identifying "at-risk survivors" of deteriorated QOL and for suggesting powerful strategies (eg, enhancing self-efficacy or social support) for improving QOL.
Collapse
Affiliation(s)
- Soo Hyun Kim
- Author Affiliations: Department of Nursing, Inha University, Incheon, South Korea
| | | | | | | | | |
Collapse
|
4
|
Jalili S, Ghasemi Shayan R. A Comprehensive Evaluation of Health-Related Life Quality Assessment Through Head and Neck, Prostate, Breast, Lung, and Skin Cancer in Adults. Front Public Health 2022; 10:789456. [PMID: 35493355 PMCID: PMC9051448 DOI: 10.3389/fpubh.2022.789456] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 03/07/2022] [Indexed: 11/13/2022] Open
Abstract
Health assessment data assists the well-being and patient care teams' process in drawing up a care and assistance plan and comprehending the requirements of the patient. Comprehensive and precise data about the Quality of Life of cancer patients play a significant part in the development and organization of cancer patient care. Quality of Life has been used to mean a variety of various things, such as health situation, physical function, symptoms, psychosocial modification, well-being, enjoyment of life, and happiness. Chronic diseases such as cancer are among the disorders that severely affect people's health and consequently their Quality of Life. Cancer patients experience a range of symptoms, including pain and various physical and mental conditions that negatively affect their Quality of Life. In this article, we examined cancer and the impact that this disease can have on the Quality of Life of cancer patients. The cancers examined in this article include head and neck, prostate, breast, lung, and skin cancers. We also discussed health assessment and the importance and purpose of studying patients' Quality of Life, especially cancer patients. The various signs and symptoms of the disease that affect the Quality of Life of patients were also reviewed.
Collapse
Affiliation(s)
- Shirin Jalili
- Department of Surgical Technology, Islamic Azad University of Sarab, Sarab, Iran
| | - Ramin Ghasemi Shayan
- Department of Radiology, Paramedical Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
5
|
Kim W, Han KT, Kim S. Health-related quality of life among cancer patients and survivors and its relationship with current employment status. Support Care Cancer 2022; 30:4547-4555. [PMID: 35119519 DOI: 10.1007/s00520-022-06872-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 01/27/2022] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Health-related quality of life (HRQoL) is an important end point to measure in cancer patients and survivors. This study investigated whether differences in HRQOL exist between cancer patients, cancer survivors, and the general population, in addition to how employment status interplays in this relationship. METHODS Data were from the 2019 Korea National Health & Nutrition Examination. HRQoL was measured using the HRQoL Instrument with 8 Items (HINT-8) index, which encompasses physical, mental, social, and health-related aspects. All variables were entered simultaneously into the fully adjusted model. Multiple regression analysis was used to evaluate the association between HRQoL in cancer patients and cancer survivors compared to the general population. An interaction analysis was conducted based on current employment status. RESULTS A total of 3805 cancer patients, 109 cancer survivors, and 3609 individuals of the general population were included in this study. The HRQoL scores of cancer patients (β: - 0.0221, p-value: 0.0218) were poorer compared to the general population with statistical significance. In contrast, the HRQoL scores of cancer survivors did not show statistically significant differences. The interaction term between cancer status and economic activity status was statistically significant for cancer patients * unemployed (β: - 0.0557, p-value: 0.0020). CONCLUSION Cancer patients had lower HRQoL than the general population. Additionally, the interaction analysis reveals that unemployed cancer patients have poorer HRQoL scores than the employed general population. The results reveal that cancer patients are vulnerable to decreases in HRQoL, in particular those who are currently unemployed.
Collapse
Affiliation(s)
- Woorim Kim
- Division of Cancer Control & Policy, National Cancer Control Institute, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Kyu-Tae Han
- Division of Cancer Control & Policy, National Cancer Control Institute, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Seungju Kim
- Department of Nursing, College of Nursing, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
| |
Collapse
|
6
|
Wang CJ, Suh YS, Lee HJ, Park JH, Park SH, Choi JH, Alzahrani F, Alzahrani K, Kong SH, Park DJ, Cao H, Yang HK. Postoperative quality of life after gastrectomy in gastric cancer patients: a prospective longitudinal observation study. Ann Surg Treat Res 2022; 103:19-31. [PMID: 35919110 PMCID: PMC9300440 DOI: 10.4174/astr.2022.103.1.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 05/18/2022] [Accepted: 06/02/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose 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. Methods 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). Results 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. Conclusion 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.
Collapse
Affiliation(s)
- Chao-Jie Wang
- 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
| | - Yun-Suhk Suh
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyuk-Joon Lee
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Ji-Hyeon Park
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
- Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Shin-Hoo Park
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
- Division of Foregut Surgery, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jong-Ho Choi
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
- Department of Surgery, Eulji University, Seoul, Korea
| | - Fadhel Alzahrani
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
- Department of Surgery, Al-Noor Specialist Hospital, Makkah, Saudi Arabia
| | - Khalid Alzahrani
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
- Department of Surgery, Taif University, College of Medicine, Taif, Saudi Arabia
| | - Seong-Ho Kong
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Do-Joong Park
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Hui Cao
- Department of Gastrointestinal Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Han-Kwang Yang
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
| |
Collapse
|
7
|
Min JS, Jeong SH, Park JH, Kim T, Jung EJ, Ju YT, Jeong CY, Kim JY, Park M, Lee YJ. A comparison of quality of life between patients with small and large gastric remnant volumes after gastrectomy for gastric cancer. Medicine (Baltimore) 2021; 100:e26954. [PMID: 34414961 PMCID: PMC8376383 DOI: 10.1097/md.0000000000026954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 07/24/2021] [Indexed: 01/04/2023] Open
Abstract
The impact of gastric remnant volumes (GRVs) after gastrectomy on patients' quality of life (QOL) has not yet been clarified. The aim of the present study was to compare QOL after gastrectomy between small and large gastric remnant volume patients.We prospectively collected clinical data from 78 consecutive patients who underwent distal gastrectomy with Billroth II gastrojejunostomy for gastric cancer. The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Stomach questionnaire and gastric computed tomography scans were performed. The patients were subdivided into 2 groups by remnant stomach volume (the S group ≤110 mL vs L group >110 mL).The worst scores for most items were observed at postoperative month 1 and usually improved thereafter. There was no difference in the STO22 score except for dysphagia between the S and L groups after gastrectomy (P > .05). The QOL score of dysphagia was different at postoperative 6 months (S vs L, 12.4 vs 22.8, P < .03), but there was no difference at postoperative months 1, 3, 12, 24, or 36 (P > .05).The remnant gastric volume after partial gastrectomy affects neither functional differences nor QOL after 6 months following appropriate radical surgery.
Collapse
Affiliation(s)
- Jae-Seok Min
- Department of Surgery, Dongnam Institute of Radiological and Medical Sciences, Cancer Center, Busan, South Korea
| | - Sang-Ho Jeong
- Department of Surgery, Gyeongsang National University College of Medicine and Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Ji-Ho Park
- Department of Surgery, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, South Korea
| | - Taehan Kim
- Department of Surgery, Gyeongsang National University College of Medicine and Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Eun-Jung Jung
- Department of Surgery, Gyeongsang National University College of Medicine and Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Young-Tae Ju
- Department of Surgery, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, South Korea
| | - Chi-Young Jeong
- Department of Surgery, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, South Korea
| | - Ju-Yeon Kim
- Department of Surgery, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, South Korea
| | - Miyeong Park
- Department of Anesthesiology, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Young-Joon Lee
- Department of Surgery, Gyeongsang National University College of Medicine and Gyeongsang National University Changwon Hospital, Changwon, South Korea
| |
Collapse
|
8
|
Eom BW, Lee J, Lee IS, Son YG, Ryu KW, Kim SG, Kim HI, Kim YW, Kong SH, Kwon OK, Park JH, An JY, Kim CH, Suh BJ, Yoon HM, Son MW, Park JY, Park JM, Jeong SH, Yoo MW, Song GJ, Yang HK, Suh YS, Park KB, Ahn SH, Shin DW, Jee YS, Ahn HS, Lee S, Min JS, In H, Kim A, Hur H, Lee HJ. Development and Validation of a Symptom-Focused Quality of Life Questionnaire (KOQUSS-40) for Gastric Cancer Patients after Gastrectomy. Cancer Res Treat 2021; 53:763-772. [PMID: 33421981 PMCID: PMC8291178 DOI: 10.4143/crt.2020.1270] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 12/28/2020] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Patients who have undergone gastrectomy have unique symptoms that are not appropriately assessed using currently available tools. This study developed and validated a symptom-focused quality of life (QoL) questionnaire for patients who have received gastrectomy for gastric cancer. MATERIALS AND METHODS Based on a literature review, patient interviews, and expert consultation by the KOrean QUality of life in Stomach cancer patients Study group (KOQUSS), the initial item pool was developed. Two large-scale developmental studies were then sequentially conducted for exploratory factor analyses for content validity and item reduction. The final item pool was validated in a separate cohort of patients and assessed for internal consistency, test-retest reliability, construct validity, and clinical validity. RESULTS The initial questionnaire consisted of 46-items in 12 domains. Data from 465 patients at 11 institutions, followed by 499 patients at 13 institutions, were used to conduct item reduction and exploratory factor analyses. The final questionnaire (KOQUSS-40) comprised 40 items within 11 domains. Validation of KOQUSS-40 was conducted on 413 patients from 12 hospitals. KOQUSS-40 was found to have good model fit. The mean summary score of the KOQUSS-40 was correlated with the EORTC QLQ-C30 and STO22 (correlation coefficients, 0.821 and 0.778, respectively). The KOQUSS-40 score was also correlated with clinical factors, and had acceptable internal consistency (> 0.7). Test-retest reliability was greater than 0.8. CONCLUSION The KOQUSS-40 can be used to assess QoL of gastric cancer patients after gastrectomy and allows for a robust comparison of surgical techniques in clinical trials.
Collapse
Affiliation(s)
- Bang Wool Eom
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Joongyub Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - In Seob Lee
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young-Gil Son
- Department of Surgery, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Keun Won Ryu
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Sung Geun Kim
- Department of Surgery, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyoung-Il Kim
- Department of Surgery, Yonsei University Severance Hospital, Seoul, Korea
| | - Young-Woo Kim
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Seong-Ho Kong
- Department Surgery and Cancer Research Institute, Seoul National University Hospital, Seoul National University of College of Medicine, Seoul, Korea
| | - Oh Kyoung Kwon
- Department of Surgery, Kyungpook National University Chilgok Hospital, Daegu, Korea
| | - Ji-Ho Park
- Department of Surgery, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Ji Yeong An
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chang Hyun Kim
- Department of Surgery, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Byoung-Jo Suh
- Department of Surgery, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Hong Man Yoon
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Myoung Won Son
- Department of Surgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Ji Yeon Park
- Department of Surgery, Kyungpook National University Chilgok Hospital, Daegu, Korea
| | - Jong-Min Park
- Department of Surgery, National Medical Center, Seoul, Korea
| | - Sang-Ho Jeong
- Department of Surgery, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Moon-Won Yoo
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Geum Jong Song
- Department of Surgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Han-Kwang Yang
- Department Surgery and Cancer Research Institute, Seoul National University Hospital, Seoul National University of College of Medicine, Seoul, Korea
| | - Yun-Suhk Suh
- Department Surgery and Cancer Research Institute, Seoul National University Hospital, Seoul National University of College of Medicine, Seoul, Korea
| | - Ki Bum Park
- Department of Surgery, Kyungpook National University Chilgok Hospital, Daegu, Korea
| | - Sang-Hoon Ahn
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Dong Woo Shin
- Department of Surgery, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Ye Seob Jee
- Department of Surgery, Dankook University Hospital, Cheonan, Korea
| | - Hye-Seong Ahn
- Department of Surgery, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Sol Lee
- Department of Surgery, Seoul Medical Center, Seoul, Korea
| | - Jae Seok Min
- Department of Surgery, Dongnam Institute of Radiological and Medical Sciences, Busan, Korea
| | - Haejin In
- Department of Surgery, Albert Einstein College of Medicine, New York, NY, USA
| | - Ahyoung Kim
- Department of Psychology, Ewha Womans University, Seoul, Korea
| | - Hoon Hur
- Department of Surgery, Ajou University Hospital, Suwon, Korea
| | - Hyuk-Joon Lee
- Department Surgery and Cancer Research Institute, Seoul National University Hospital, Seoul National University of College of Medicine, Seoul, Korea
| |
Collapse
|
9
|
Lee MK, Oh J. Patient-Reported Outcomes of Regular Aerobic Exercise in Gastric Cancer. Cancers (Basel) 2021; 13:cancers13092080. [PMID: 33923080 PMCID: PMC8123334 DOI: 10.3390/cancers13092080] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 04/16/2021] [Accepted: 04/22/2021] [Indexed: 01/01/2023] Open
Abstract
Simple Summary The benefits of exercise for health-related quality of life (HRQOL) and depression in patients with gastric cancer remain unclear. Thus this research was suggested to examine the association between maintenance of regular aerobic exercise at a recommended level and depression and HRQOL in patients with gastric cancer during or after treatment. The findings indicated that exercise can have a synergistic effect on improvement in HRQOL via indirect positive effects on depression and direct effects on HRQOL in patients with gastric cancer. The findings of this research may add the evidence on the benefits of exercise for HRQOL and depression in patients with gastric cancer to the research community. Abstract The benefits of exercise for health-related quality of life (HRQOL) and depression in patients with gastrointestinal disease remain unclear, and studies on gastric cancer are scant. This study examines the association between the maintenance of regular aerobic exercise at a recommended level and depression and HRQOL in patients with gastric cancer during or after treatment. In this cross-sectional study, a face-to-face survey was used to collect data from 126 patients with primary gastric cancer during or after treatment in a tertiary acute-care hospital in Korea. Regular exercise was defined as regularly maintained aerobic exercise of at least moderate intensity consuming ≥4 metabolic equivalents for ≥150 min/wk for at least 6 months. Depression was measured using the 9-item version of the Patient Health Questionnaire, and HRQOL was assessed using the EORTC QLQ-C30. Patients who maintained aerobic exercise at a recommended level were less likely to have depression and more likely to have improved global QOL, as well as physical, role, and emotional functioning. Patients with depression were less likely to report improved global QOL and functioning. Thus, exercise can have a synergistic effect on improvement in HRQOL via indirect positive effects on depression and direct effects on HRQOL in patients with gastric cancer. Oncology nurses should encourage patients with gastric cancer who suffer from a depressive mood to set up and implement specific plans for practicing regular exercise, which can lead to an improvement in both depression and HRQOL.
Collapse
Affiliation(s)
- Myung-Kyung Lee
- College of Nursing, Research Institute of Nursing Science, Kyungpook National University, Daegu 41944, Korea;
| | - Jihyun Oh
- Department of Nursing, Daejeon University, Daejeon 34520, Korea
- Correspondence: or ; Tel.: +82-42-280-4652
| |
Collapse
|
10
|
Choi JH, Han SU, Yang HK, Kim YW, Ryu KW, Park JM, An JY, Kim MC, Park S, Song KY, Oh SJ, Kong SH, Suh BJ, Yang DH, Ha TK, Kim HI, Hyung WJ, Lee HJ. The pattern of postoperative quality of life following minimally invasive gastrectomy for gastric cancer: a prospective cohort from Korean multicenter robotic gastrectomy trial. Ann Surg Treat Res 2020; 99:275-284. [PMID: 33163457 PMCID: PMC7606131 DOI: 10.4174/astr.2020.99.5.275] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 07/13/2020] [Accepted: 08/11/2020] [Indexed: 02/08/2023] Open
Abstract
Purpose Quality of life (QOL) has become important in the trend of emphasizing patient satisfaction. This study aimed to evaluate the QOL in patients who underwent laparoscopic or robotic gastrectomy for gastric cancer. Methods A prospective trial was performed involving patients who underwent laparoscopic or robotic gastrectomy for primary gastric cancer at 11 hospitals in Korea. Within this comparative trial, QOL, postoperative pain, and long-term complications were exanimated. The quality-of-life questionnaire (QLQ)-C30 and QLQ-STO22 developed by the European Organization for Research and Treatment of Cancer were used for the QOL survey. We compared the data after dividing it into several types of characteristics as follows; device (robotic or laparoscopic), operation type, pathological stage, and sex. Biased components were extracted by logistic regression analysis. Propensity score matching was applied to the data set with the biased components. Results In total, 434 patients (211 for laparoscopic surgery and 223 for robotic surgery) were enrolled, out of which 321 patients who responded to both preoperative and postoperative surveys were selected for analysis. Robotic gastrectomy was not different from laparoscopic gastrectomy with respect to postoperative QOL. Distal gastrectomy showed better scores than total gastrectomy in terms of role functioning, social functioning, fatigue, nausea/vomiting, pain, dyspnea, constipation, financial difficulties, dysphagia, eating restrictions, anxiety, taste, and body image. Male patients showed better scores on the 19 scales compared to female patients. Conclusion Robotic and laparoscopic approaches for gastric cancer surgery did not differ from each other with respect to QOL. Distal gastrectomy resulted in better QOL than total gastrectomy.
Collapse
Affiliation(s)
- Jong-Ho Choi
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Sang-Uk Han
- Department of Surgery, Ajou University College of Medicine, Suwon, Korea
| | - Han-Kwang Yang
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Young-Woo Kim
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Keun Won Ryu
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Joong-Min Park
- Department of Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - Ji Yeong An
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Min-Chan Kim
- Department of Surgery, Dong-A University College of Medicine, Busan, Korea
| | - Sungsoo Park
- Department of Surgery, Korea University College of Medicine, Seoul, Korea
| | - Kyo Young Song
- Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung Jin Oh
- Department of Surgery, Inje University College of Medicine, Busan, Korea
| | - Seong-Ho Kong
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Byoung Jo Suh
- Department of Surgery, Inje University College of Medicine, Busan, Korea
| | - Dae Hyun Yang
- Department of Surgery, Hallym University College of Medicine, Seoul, Korea
| | - Tae Kyung Ha
- Department of Surgery, Hanyang University College of Medicine, Seoul, Korea
| | - Hyoung-Il Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Woo Jin Hyung
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Hyuk-Joon Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
11
|
Using a Chinese time trade-off approach to explore the health utility level and quality of life of cancer patients in urban China: a multicentre cross-sectional study. Support Care Cancer 2020; 29:2215-2223. [PMID: 32892304 DOI: 10.1007/s00520-020-05729-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 08/28/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE A quality of life assessment is useful in identifying a specific health impact on patients who are suffering from various medical conditions. This study estimated the quality of life among patients with cancers of the lungs, breast, colorectum, oesophagus, liver, and stomach in urban China and evaluates the associated factors. METHODS This study employed a random cluster sampling strategy to recruit patients with lung, breast, colorectal, oesophageal, liver, or stomach cancer from eleven third-grade class-A (the highest level) hospitals in Beijing between October 2013 and May 2014. We performed a quality of life survey that included solicitation of sociodemographic and clinical information and the use of a EuroQoL five-dimension three-level questionnaire. We applied the Chinese time trade-off method to calculate the health utility values, which were transformed into binary variables (using the median as the cut-off). In addition, multivariable logistic regression analysis was used to examine the factors associated with the quality of life. RESULTS A total of 637 patients (91 with lung cancer, 152 with breast cancer, 60 with colorectal cancer, 108 with oesophageal cancer, 154 with liver cancer, and 72 with stomach cancer) were included in this study; the medians of the health utility values were 0.780, 0.800, 0.800, 0.860, 0.800, and 0.870, respectively. The most common concerns for patients of all six cancer types were pain/discomfort and anxiety/depression. The reported health status of patients was associated with various demographic and clinical variables. CONCLUSION This study highlighted that pain relief and psychological support are important aspects of patient management for those with these types of cancer. Individuals with factors associated with a poorer quality of life should be targets for additional support.
Collapse
|
12
|
Xia R, Zeng H, Liu Q, Liu S, Zhang Z, Liu Y, Guo G, Song G, Zhu Y, Wu X, Song B, Liao X, Chen Y, Wei W, Chen G, Chen W, Zhuang G. Health-related quality of life and health utility score of patients with gastric cancer: A multi-centre cross-sectional survey in China. Eur J Cancer Care (Engl) 2020; 29:e13283. [PMID: 32602238 DOI: 10.1111/ecc.13283] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 02/05/2020] [Accepted: 06/08/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE 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. METHODS 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. RESULTS 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. CONCLUSIONS Gastric cancer significantly impaired patients' HRQoL in daily life after treatment. More advanced cancer stages were associated with larger decrements on health state utility.
Collapse
Affiliation(s)
- Ruyi Xia
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Hongmei Zeng
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qian Liu
- Xi'an Center for Disease Control and Prevention, Xi'an, China
| | | | - Zhiyi Zhang
- Wuwei Cancer Hospital of Gansu Province, Wuwei, China
| | - Yuqin Liu
- Gansu Provincial Cancer Hospital, Lanzhou, China
| | | | - Guohui Song
- Cixian Institute for Cancer Prevention and Control, Cixian Cancer Hospital, Handan, China
| | - Yigong Zhu
- Luoshan Center for Disease Control and Prevention, Xinyang, China
| | - Xianghong Wu
- Center for Disease Control and Prevention of Sheyang County, Yancheng, China
| | - Bingbing Song
- Tumor Prevention and Treatment Institute, Harbin Medical University, Harbin, China
| | | | - Yanfang Chen
- Yueyang Lou District Center for Disease Prevention and Control, Yueyang, China
| | - Wenqiang Wei
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Gang Chen
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, Vic., Australia
| | - Wanqing Chen
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guihua Zhuang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| |
Collapse
|
13
|
Carrillo González GM, Santamaria NP, Oliveros Wilches R. Follow-up of Gastrectomized Patients due to Gastric Cancer in a Cancer Center of Bogota, Colombia. AQUICHAN 2019. [DOI: 10.5294/aqui.2019.19.2.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective: To determine the perceived burden and functional status of gastric cancer patients with gastrectomy in a center of cancer in Bogota (Colombia) between 2013 and 2016. Materials and methods: Retrospective description of patients intervened by gastrectomy distributed in three groups: Patients with gastrectomy from 1 to 12 months of surgical intervention, 13 to 14 months and 25 to 36 months. For this, it was used the disease burden perception instrument and the Karnofsky scale. Results: 127 patients were included. 63 from 1 to 12 months, 43 from 13 to 24 months, and 21 from 25 to 36 months of intervention. Gastric adenocarcinoma of intestinal pattern stage III and II predominate. More than 50 % of the patients required total gastrectomy and received adjuvant chemotherapy. The majority of participants performed regular activities with mild signs and symptoms, presented low overall perceived burden and functional performance without statistically significant differences between groups. Patients from 1 to 12 months of intervention reported greater levels of physical discomfort. Conclusions: In patients with gastrectomy for gastric cancer, physical symptoms persist such as emotional disturbances, economic difficulties and limitations in the work role, findings to be included in follow-up programs.
Collapse
|
14
|
Vivir después de una gastrectomía: experiencia de pacientes con cáncer gástrico. ENFERMERIA CLINICA 2019; 29:27-33. [DOI: 10.1016/j.enfcli.2018.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 06/06/2018] [Accepted: 06/09/2018] [Indexed: 01/07/2023]
|
15
|
Ishii K, Tsubosa Y, Niihara M, Akai T, Soneda W. Changes in the nutritional status of elderly patients after esophagectomy. Esophagus 2019; 16:408-412. [PMID: 31243591 PMCID: PMC6744378 DOI: 10.1007/s10388-019-00681-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 06/16/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND Esophagectomy is a highly invasive procedure for patients aged > 70 years. Here, we compared the actual nutritional status of older and younger patients who underwent esophagectomy. METHODS A total of 118 patients who underwent radical esophagectomy between April 2013 and December 2016 were enrolled and divided into two groups based on age: group A (n = 41; ≥ 70 years) and group B (n = 77; < 70 years). Data pertaining to body mass index and nutritional variables (albumin; total cholesterol; cholinesterase; and prealbumin) were retrospectively analyzed preoperatively and at 3, 6, and 12 months postoperatively. RESULTS Significant preoperative between-group differences were found in the cholinesterase, albumin, and prealbumin levels. The body mass index gradually decreased over the first 12 months after surgery in both groups, without significant between-group differences. Significant differences were observed in prealbumin and cholinesterase levels at 3 months postoperatively. 1 year postoperatively, both groups showed slight improvements; however, the between-group differences were not statistically significant. Group A had a significantly lower amount of the degree of decrement of BMI and chE than group B. CONCLUSION Thus, patients aged > 70 years can recover within 12 months of esophagectomy.
Collapse
Affiliation(s)
- Kenjiro Ishii
- 0000 0004 1774 9501grid.415797.9Department of Esophageal Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Suntou-Gun, Shizuoka 411-8777 Japan
| | - Yasuhiro Tsubosa
- 0000 0004 1774 9501grid.415797.9Department of Esophageal Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Suntou-Gun, Shizuoka 411-8777 Japan
| | - Masahiro Niihara
- 0000 0004 1774 9501grid.415797.9Department of Esophageal Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Suntou-Gun, Shizuoka 411-8777 Japan
| | - Toshiya Akai
- 0000 0004 1774 9501grid.415797.9Department of Esophageal Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Suntou-Gun, Shizuoka 411-8777 Japan
| | - Wataru Soneda
- 0000 0004 1774 9501grid.415797.9Department of Esophageal Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Suntou-Gun, Shizuoka 411-8777 Japan
| |
Collapse
|
16
|
Carrillo GM, Bayona HA, Arias EM. Perfil y carga de la enfermedad de personas con cáncer gástrico sometidas a gastrectomía. REVISTA DE LA FACULTAD DE MEDICINA 2018. [DOI: 10.15446/revfacmed.v66n1.60273] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introducción. Los tratamientos quirúrgicos del cáncer gástrico implican adaptaciones a un nuevo estilo de vida ligado a la limitación que pueden ocasionar carga.Objetivos. Determinar el perfil y la carga de adultos con cáncer gástrico que han sido sometidos a gastrectomía en una institución de oncología en Bogotá.Materiales y métodos. Estudio de abordaje cuantitativo y corte transversal que incluyó 60 pacientes con cáncer gástrico posgastrectomía, en su mayoría hombres de estratos socioeconómicos bajos y mínimos niveles de escolaridad, con una edad promedio de 56.33 años. Se utilizó una encuesta de caracterización y el instrumento carga de la enfermedad para el paciente.Resultados. Predomina el adenocarcinoma gástrico intestinal avanzado y la gastrectomía total como cirugía de elección que genera mayor carga. Se identifica alta carga emocional por angustia, tristeza e incertidumbre y baja carga física por síntomas como molestias gastrointestinales, agotamiento y debilidad. Las dificultades económicas y la alteración del rol laboral generan carga sociofamiliar y cultural. Hay relación inversa y estadísticamente significativa entre el estado funcional del paciente y el agotamiento, la fatiga, la alteración del equilibrio y las alteraciones del sueño.Conclusiones. Los sobrevivientes de cáncer gástrico posgrastectomía presentan carga emocional, sociofamiliar y cultural que requiere ser atendida.
Collapse
|
17
|
Lee HJ, Ock M, Kim KP, Jo MW. Estimation of population-based utility weights for gastric cancer-related health states. Patient Prefer Adherence 2018; 12:909-918. [PMID: 29872276 PMCID: PMC5973464 DOI: 10.2147/ppa.s151946] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND This study aimed to generate utility weights of gastric cancer-related health states from the perspective of the Korean general population. METHODS The Korean adults (age ≥19 years) included in the study were sampled using multistage quota sampling methods stratified by sex, age, and education level. Nine scenarios for hypothetical gastric cancer-related health states were developed and reviewed. After consenting to participate, the subjects were surveyed by trained interviewers using a computer-assisted personal interview method. Participants were asked to perform standard gamble tasks to measure the utility weights of 5 randomly assigned health states (from among nine scenarios). The mean utility weight was calculated for each health state. RESULTS Three hundred twenty-six of the 407 adults who completed this study were included in the analysis. The mean utility weights from the standard gamble were 0.857 (no gastric cancer with Helicobacter pylori infection), 0.773 (early gastric cancer [EGC] with endoscopic surgery), 0.779 (EGC with subtotal gastrectomy), 0.767 (EGC with total gastrectomy), 0.602 (advanced gastric cancer with subtotal gastrectomy and adjuvant chemotherapy), 0.643 (advanced gastric cancer with total gastrectomy and adjuvant chemotherapy), 0.522 (advanced gastric cancer with extended gastrectomy and adjuvant chemotherapy), 0.404 (metastatic gastric cancer with palliative chemotherapy), and 0.399 (recurrent gastric cancer with palliative chemotherapy). CONCLUSION This study was the first to comprehensively estimate the utility weights of gastric cancer-related health states in a general population. The utility weights derived from this study could be useful for future economic evaluations related to gastric cancer interventions.
Collapse
Affiliation(s)
- Hyeon-Jeong Lee
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Minsu Ock
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Kyu-Pyo Kim
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Min-Woo Jo
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
- Correspondence: Min-Woo Jo, Department of Preventive Medicine, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea, Tel +822 3010 4264, Fax +822 477 2898, Email
| |
Collapse
|
18
|
Total Gastrectomy for Hereditary Diffuse Gastric Cancer at a Single Center: Postsurgical Outcomes in 41 Patients. Ann Surg 2017; 266:1006-1012. [PMID: 27759617 DOI: 10.1097/sla.0000000000002030] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The aim of this study was to describe postoperative outcomes of total gastrectomy at our institution for patients with hereditary diffuse gastric cancer (HDGC). BACKGROUND HDGC, which is mainly caused by germline mutations in the E-cadherin gene (CDH1), renders a lifetime risk of gastric cancer of up to 70%, prompting a recommendation for prophylactic total gastrectomy. METHODS A prospective gastric cancer database identified 41 patients with CDH1 mutation who underwent total gastrectomy during 2005 to 2015. Perioperative, histopathologic, and long-term data were collected. RESULTS Of the 41 patients undergoing total gastrectomy, median age was 47 years (range 20 to 71). There were 14 men and 27 women, with 25 open operations and 16 minimally invasive operations. Median length of stay was 7 days (range 4 to 50). In total, 11 patients (27%) experienced a complication requiring intervention, and there was 1 peri-operative mortality (2.5%). Thirty-five patients (85%) demonstrated 1 or more foci of intramucosal signet ring cell gastric cancer in the examined specimen. At 16 months median follow-up, the median weight loss was 4.7 kg (15% of preoperative weight). By 6 to 12 months postoperatively, weight patterns stabilized. Overall outcome was reported to be "as expected" by 40% of patients and "better than expected" by 45%. Patient-reported outcomes were similar to those of other patients undergoing total gastrectomy. CONCLUSION Total gastrectomy should be considered for all CDH1 mutation carriers because of the high risk of invasive diffuse-type gastric cancer and lack of reliable surveillance options. Although most patients have durable weight loss after total gastrectomy, weights stabilize at about 6 to 12 months postoperatively, and patients report outcomes as being good to better than their preoperative expectations. No patients have developed gastric cancer recurrence after resections.
Collapse
|
19
|
Ahn S, Jung H, Kim S, Shin SJ, Park CG, Chu SH. Quality of life among Korean gastrointestinal cancer survivors. Eur J Oncol Nurs 2017; 30:15-21. [DOI: 10.1016/j.ejon.2017.07.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 06/22/2017] [Accepted: 07/03/2017] [Indexed: 12/30/2022]
|
20
|
Park KB, Park JY, Lee SS, Kwon OK, Chung HY, Yu W. Impact of Body Mass Index on the Quality of Life after Total Gastrectomy for Gastric Cancer. Cancer Res Treat 2017; 50:852-860. [PMID: 28903552 PMCID: PMC6056960 DOI: 10.4143/crt.2017.080] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 09/04/2017] [Indexed: 12/26/2022] Open
Abstract
Purpose We evaluated the impact of postoperative body mass index (BMI) shifts on the quality of life (QoL) following total gastrectomy in patients with gastric cancer. Materials and Methods QoL data collected from the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-C30 and QLQ-STO22 questionnaires were obtained from 417 patients preoperatively and 1 year after surgery. Patients were divided into two groups based on changes in BMI: group 1 comprised patientswhose BMIrange category dropped, and group 2 included patients who maintained or rose to a higher category compared to their preoperative BMI category. Results There were 276 patients in group 1 and 141 in group 2. QoLs with respect to the global health status and functional scales were not significantly different between the groups 1 year after surgery. However, there were significantly greater decreases in QoL in group 1 due to gastrointestinal symptoms, such as nausea and vomiting (p=0.008), appetite loss (p=0.001), and constipation (p=0.038). Of the QLQ-STO22 parameters, dysphagia (p=0.013), pain (p=0.012), reflux symptoms (p=0.017), eating restrictions (p=0.007), taste (p=0.009), and body image (p=0.009) were associated with significantly worse QoL in group 1 than in group 2 1 year after surgery. Conclusion Patients have significantly different QoLs depending on the BMI shift after total gastrectomy. Efforts to reduce the gap in QoL should include intensive nutritional support and restoration of dietary behaviors. Appropriate clinical and institutional approaches, plus active medical interventions, are required for maintaining patients' BMIs after surgery.
Collapse
Affiliation(s)
- Ki Bum Park
- Gastric Cancer Center, Kyungpook National University Medical Center, Daegu, Korea
| | - Ji Yeon Park
- Gastric Cancer Center, Kyungpook National University Medical Center, Daegu, Korea
| | - Seung Soo Lee
- Department of Surgery, Kyungpook National University Hospital, Daegu, Korea
| | - Oh Kyoung Kwon
- Gastric Cancer Center, Kyungpook National University Medical Center, Daegu, Korea
| | - Ho Young Chung
- Department of Surgery, Kyungpook National University Hospital, Daegu, Korea
| | - Wansik Yu
- Gastric Cancer Center, Kyungpook National University Medical Center, Daegu, Korea
| |
Collapse
|
21
|
Park KB, Lee SS, Kwon OK, Chung HY, Yu W. Chronological Changes in Quality of Life after Distal Gastrectomy for Gastric Cancer. J Gastric Cancer 2017; 17:110-119. [PMID: 28680716 PMCID: PMC5489540 DOI: 10.5230/jgc.2017.17.e14] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 04/13/2017] [Accepted: 04/24/2017] [Indexed: 12/30/2022] Open
Abstract
PURPOSE Patient quality of life (QoL) may be severely disrupted following distal gastrectomy for gastric cancer. This issue should be addressed to improve postoperative care. MATERIALS AND METHODS QoL data from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, and its gastric cancer-specific module, were administered to 202 patients preoperatively, and 5 years postoperatively. Patients were classified into subgroups based on their answers to each questionnaire item: group I (good), answering "not at all"; group II (fair), answering "a little"; group III (poor), answering "quite a bit" or "very much." RESULTS At 5 years post-operation, the proportion of patients in group III on the functional scales ranged from 4.3% to 5.7%. The proportions of patients in group III with fatigue, insomnia, diarrhea, and financial difficulties were 8.9%, 9.0%, 11.5%, and 9.1%, respectively. The proportions of patients in group III with anxiety, dry mouth, body image concerns, and hair loss were 12.8%, 10.5%, 9.9%, and 12.6%, respectively. These proportions were less than 5% for other QoL symptom scales/items and for the gastric cancer-specific module. CONCLUSIONS Most patients reported good or fair QoL following surgery. However, symptom management of fatigue, insomnia, diarrhea, anxiety, dry mouth, body image, and hair loss should be specifically targeted for long-term patient care in approximately 10% of patients.
Collapse
Affiliation(s)
- Ki Bum Park
- Gastric Cancer Center, Kyungpook National University Medical Center, Daegu, Korea
| | - Seung Soo Lee
- Department of Surgery, Kyungpook National University Hospital, Daegu, Korea
| | - Oh Kyoung Kwon
- Gastric Cancer Center, Kyungpook National University Medical Center, Daegu, Korea
| | - Ho Young Chung
- Department of Surgery, Kyungpook National University Hospital, Daegu, Korea
| | - Wansik Yu
- Gastric Cancer Center, Kyungpook National University Medical Center, Daegu, Korea
| |
Collapse
|
22
|
Long-term Quality of Life After Distal Subtotal and Total Gastrectomy: Symptom- and Behavior-oriented Consequences. Ann Surg 2016; 263:738-44. [PMID: 26501699 DOI: 10.1097/sla.0000000000001481] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE This study assessed long-term quality of life (QoL) after subtotal gastrectomy (STG) and total gastrectomy (TG) by comparing groups matched by a set of patient factors at and beyond postoperative 5 years. The cause of QoL gaps based on symptomatic and behavioral consequences of surgery were investigated. BACKGROUND Survivors after STG and TG were matched by a set of patient factors (age, sex, stage, chemotherapy, and postoperative period). QoL data were obtained from 53 and 36 pairs of survivors at and beyond postoperative 5 years, respectively. METHODS The European Organization for Research and Treatment of Cancer QoL Questionnaire (QLQ)-C30 and QLQ-STO22 were used to assess QoL. QoL comparisons between STG and TG groups were made for 5-year survivors and long-term survivors. RESULTS Five-year survivors after TG showed significantly worse QoL in social functioning, nausea and vomiting, eating restrictions, and taste. For long-term survivors, QoL inferiority of the TG group was observed only in eating restrictions. Among 4 items constituting eating restrictions, the TG group tended to exhibit worse QoL in 2 items (enjoyable meals and social meals). CONCLUSIONS Although 5-year survivors after TG still suffer from QoL inferiority from symptomatic and behavioral consequences of surgery, inferiority from behavioral consequences will persist even after symptomatic inferiority to STG survivors is no longer valid. Efforts to ameliorate persistent QoL inferiority in TG survivors should be directed toward restoring dietary behaviors, where TG survivors are prevented from enjoyable meals and social meals.
Collapse
|
23
|
Yu W, Park KB, Chung HY, Kwon OK, Lee SS. Chronological Changes of Quality of Life in Long-Term Survivors after Gastrectomy for Gastric Cancer. Cancer Res Treat 2016; 48:1030-6. [PMID: 27004956 PMCID: PMC4946352 DOI: 10.4143/crt.2015.398] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 12/19/2015] [Indexed: 02/07/2023] Open
Abstract
Purpose A few studies have prospectively evaluated changes in quality of life (QoL) after surgery in short-term survivors; however, no prospective study has evaluated the longitudinal changes in QoL in long-terms survivors. We prospectively evaluated the chronological changes in QoL after a gastrectomy over a 5-year postoperative period in a large group of patients. Materials and Methods QoL data from the European Organization for Research and Treatment of Cancer QLQ-C30 and the QLQ-STO22 questionnaires were obtained from 254 patients who completed the entire series of QoL assessments preoperatively and at 1, 2, 3, 4, and 5 years after surgery. Results There was no statistically significant change in global health status/QoL during the 5-year postoperative period. Decreases in QoL from upper gastrointestinal symptoms including diarrhea (p < 0.001), dysphagia (p < 0.001), reflux symptoms (p=0.029), and eating restrictions (p < 0.001) were observed among the long-term survivors. Decreased physical functioning (p < 0.001), role functioning (p < 0.001), and cognitive functioning (p < 0.001), along with fatigue (p=0.045) and a poor body image (p=0.003), negatively impacted the patients’ QoL for a long time. Conclusion Management of gastrointestinal symptoms should be specifically targeted as a part of long-term patient care after a gastrectomy. Proper nutritional care will improve food intake resulting in weight gain and improved physical functioning, role functioning, and body image. In addition, patients should be encouraged to preserve self-esteem and maintain social activity.
Collapse
Affiliation(s)
- Wansik Yu
- Department of Surgery, Kyungpook National University School of Medicine, Daegu, Korea.,Gastric Cancer Center, Kyungpook National University Medical Center, Daegu, Korea
| | - Ki Bum Park
- Gastric Cancer Center, Kyungpook National University Medical Center, Daegu, Korea
| | - Ho Young Chung
- Department of Surgery, Kyungpook National University Hospital, Daegu, Korea
| | - Oh Kyoung Kwon
- Gastric Cancer Center, Kyungpook National University Medical Center, Daegu, Korea
| | - Seung Soo Lee
- Department of Surgery, Kyungpook National University Hospital, Daegu, Korea
| |
Collapse
|
24
|
Lee KE, Son YG. Research Trends of Quality of Life after Gastrectomy among Gastric Cancer Patients in Korea. ASIAN ONCOLOGY NURSING 2016. [DOI: 10.5388/aon.2016.16.2.59] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Kyung Eun Lee
- School of Nursing, Yeungnam University College, Daegu, Korea
| | - Young Gil Son
- Department of Surgery, Keimyung University School of Medicine, Daegu, Korea
| |
Collapse
|
25
|
Tanizawa Y, Tanabe K, Kawahira H, Fujita J, Takiguchi N, Takahashi M, Ito Y, Mitsumori N, Namikawa T, Oshio A, Nakada K. Specific Features of Dumping Syndrome after Various Types of Gastrectomy as Assessed by a Newly Developed Integrated Questionnaire, the PGSAS-45. Dig Surg 2015; 33:94-103. [PMID: 26682541 DOI: 10.1159/000442217] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 11/03/2015] [Indexed: 02/05/2023]
Abstract
AIM Dumping syndrome is a well-known adverse outcome after gastrectomy, but the precise clinical features have not been described. The aim of this study was to examine global aspects of dumping syndrome and to explore factors affecting the intensity of dumping syndrome in a large cohort using a newly developed integrated questionnaire, the Post-Gastrectomy Syndrome Assessment Scale (PGSAS)-45. METHODS Eligible questionnaires retrieved from 2,368 patients after 6 types of gastrectomy were analyzed. The incidence, intensity and number of symptoms of early general, early abdominal and late dumping syndrome were examined across various types of gastrectomy, and clinical factors affecting the intensity of each category of dumping syndrome were identified by multiple regression analysis. RESULTS Dumping syndromes occurred most frequently and strongly in patients who underwent total gastrectomy with Roux-en-Y (TGRY), followed by proximal gastrectomy (PG), distal gastrectomy with Billroth-I, distal gastrectomy with Roux-en-Y, pylorus-preserving gastrectomy (PPG) and local resection (LR), in that order. Significant positive correlations among different categories of dumping syndromes were observed. TGRY, female sex, younger age, division of the celiac branch of the vagus nerve, PG and shorter postoperative period were independently related to worse dumping syndrome. CONCLUSIONS Dumping syndromes were most common after TGRY and least common after PPG and LR among the various gastrectomy procedures. Type of gastrectomy and several clinical factors were related to the intensity of dumping syndrome. PGSAS-45 could offer a useful tool for evaluating dumping syndrome after gastrectomy.
Collapse
Affiliation(s)
- Yutaka Tanizawa
- Division of Gastric Surgery, Shizuoka Cancer Center, Shizuoka, Japan
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Straatman J, van der Wielen N, Joosten PJ, Terwee CB, Cuesta MA, Jansma EP, van der Peet DL. Assessment of patient-reported outcome measures in the surgical treatment of patients with gastric cancer. Surg Endosc 2015; 30:1920-9. [PMID: 26310527 PMCID: PMC4848335 DOI: 10.1007/s00464-015-4415-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 07/06/2015] [Indexed: 02/07/2023]
Abstract
Background Gastric cancer is responsible for 10 % of all cancer-related deaths worldwide. With improved operative techniques and neo-adjuvant therapy, survival rates are increasing. Outcomes of interest are shifting to quality of life (QOL), with many different tools available. The aim of this study was to assess which patient-reported outcome measures (PROMs) are used to measure QOL after a gastrectomy for cancer. Methods A comprehensive search was conducted for original articles investigating QOL after gastrectomy. Two authors independently selected relevant articles, conducted clinical appraisal and extracted data (P.J. and J.S.). Results Out of 3414 articles, 26 studies were included, including a total of 4690 patients. These studies included ten different PROMs, which could be divided into generic, symptom-specific and disease-specific questionnaires. The EORTC and the FACT questionnaires use an oncological overall QOL module and an organ-specific module. Only one validation study regarding the use of the EORTC after surgery for gastric cancer was available, demonstrating good psychometric properties and clinical validity. Conclusions A great variety of PROMs are being used in the measurement of QOL after surgery for gastric cancer. A questionnaire with a general module along with a disease-specific module for the assessment of QOL seems most desirable, such as the EORTC and the FACT with their specific modules. Both are developed in different treatment modalities, such as in surgical patients. EORTC is the most widely used questionnaire and therefore allows for comparison of new studies to existing data. Future studies are needed to assess content validity in surgical gastric cancer patients.
Collapse
Affiliation(s)
- Jennifer Straatman
- Department of Gastrointestinal Surgery, VU University Medical Center, De Boelelaan 1117, ZH 7F020, 1081 HV, Amsterdam, The Netherlands.
| | - Nicole van der Wielen
- Department of Gastrointestinal Surgery, VU University Medical Center, De Boelelaan 1117, ZH 7F020, 1081 HV, Amsterdam, The Netherlands
| | - Pieter J Joosten
- Department of Gastrointestinal Surgery, VU University Medical Center, De Boelelaan 1117, ZH 7F020, 1081 HV, Amsterdam, The Netherlands
| | - Caroline B Terwee
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Miguel A Cuesta
- Department of Gastrointestinal Surgery, VU University Medical Center, De Boelelaan 1117, ZH 7F020, 1081 HV, Amsterdam, The Netherlands
| | - Elise P Jansma
- Medical Library, VU University Medical Center, Amsterdam, The Netherlands
| | - Donald L van der Peet
- Department of Gastrointestinal Surgery, VU University Medical Center, De Boelelaan 1117, ZH 7F020, 1081 HV, Amsterdam, The Netherlands
| |
Collapse
|
27
|
Choi JH, Kim ES, Lee YJ, Cho KB, Park KS, Jang BK, Chung WJ, Hwang JS, Ryu SW. Comparison of quality of life and worry of cancer recurrence between endoscopic and surgical treatment for early gastric cancer. Gastrointest Endosc 2015; 82:299-307. [PMID: 25892060 DOI: 10.1016/j.gie.2015.01.019] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 01/03/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND The quality of life (QOL) of patients who survive early gastric cancer (EGC) is an area of increasing interest. OBJECTIVE To compare the QOL and degree of worry of cancer recurrence in EGC patients who underwent endoscopic submucosal dissection (ESD) or surgery. DESIGN Cross-sectional study. SETTINGS A tertiary referral center. PATIENTS A total of 565 patients with EGC who received ESD or surgery. INTERVENTION Questionnaires. MAIN OUTCOME MEASUREMENTS QOL was evaluated using the Short-form Health Survey and the European Organization for Research and Treatment of Cancer QOL questionnaires (QLQ-C30 and EORTC-QLQ-STO22). Mood disorders and the worry of cancer recurrence were estimated using the Hospital Anxiety and Depression Scale (HADS) and Worry of Cancer Scale, respectively. RESULTS Questionnaires were completed by 55.7% of the ESD (137/246) and 58.9% of the surgery (188/319) patients. The surgery group had more QOL-related symptomatic and functional problems, including fatigue (P=.044), nausea/vomiting (P=.032), appetite loss (P=.023), diarrhea (P<.001), pain (P=.013), reflux symptoms (P=.005), eating restrictions (P<.001), anxiety (P=.015), taste impairment (P=.011), and poor body image (P<.001). The ESD group had significantly higher worry of cancer recurrence scores after adjusting for covariates, especially when visiting their physicians. The HADS results did not differ between the groups. LIMITATIONS Cross-sectional design. CONCLUSIONS Endoscopic treatment for EGC provides a better QOL, but stomach preservation might provoke cancer recurrence worries. Endoscopists should address this issue for relieving a patient's concern of cancer recurrence during follow-up period after ESD. ( CLINICAL TRIAL REGISTRATION NUMBER WHO ICTRP KCT0000791.).
Collapse
Affiliation(s)
- Jae Hyuk Choi
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, South Korea
| | - Eun Soo Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, South Korea
| | - Yoo Jin Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, South Korea
| | - Kwang Bum Cho
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, South Korea
| | - Kyung Sik Park
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, South Korea
| | - Byoung Kuk Jang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, South Korea
| | - Woo Jin Chung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, South Korea
| | - Jae Seok Hwang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, South Korea
| | - Seung Wan Ryu
- Department of Surgery, Keimyung University School of Medicine, Daegu, South Korea
| |
Collapse
|
28
|
Dietary alterations and restrictions following surgery for upper gastrointestinal cancers: Key components of a health-related quality of life intervention. Eur J Oncol Nurs 2015; 19:343-8. [PMID: 25697545 DOI: 10.1016/j.ejon.2015.01.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 01/14/2015] [Accepted: 01/22/2015] [Indexed: 12/31/2022]
Abstract
PURPOSE The surgical treatment of upper gastrointestinal (GI) cancers, specifically esophageal and gastric cancers, often result in extensive health-related quality of life (HRQOL) concerns, particularly those associated with dietary adjustments. This paper provides a review of HRQOL changes following esophagectomy and gastrectomy, and describes key components of an intervention to improve dietary adjustments following surgery. METHODS Intervention development was informed by 1) current published evidence on HRQOL changes for patients following upper GI surgery, 2) examination of usual post-operative care related to dietary restrictions to identify areas for continued education and support and 3) the inclusion of a conceptual framework (the Chronic Care Model) to guide intervention design and inform the selection of appropriate outcome measures. RESULTS Three key components of an HRQOL intervention are identified, and should focus on HRQOL concerns associated with dietary alterations and restrictions following treatment, involve family caregivers, and be tailored and flexible to patient and family caregiver's needs and preferences. CONCLUSIONS Evidence-based interventions to support long-term dietary alterations and restrictions following upper GI surgery are lacking, despite evidence confirming its impact on morbidity and mortality. Interventions are needed to support dietary adjustments, prevent malnutrition and excessive weight loss, and enhance HRQOL following surgery for upper GI cancers.
Collapse
|
29
|
Sim BY, Lee YW, Kim H, Kim SH. Post-traumatic growth in stomach cancer survivors: Prevalence, correlates and relationship with health-related quality of life. Eur J Oncol Nurs 2014; 19:230-6. [PMID: 25533806 DOI: 10.1016/j.ejon.2014.10.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Revised: 08/13/2014] [Accepted: 10/27/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE Post-traumatic growth (PTG) is defined as positive psychological changes experienced as a result of struggle with highly challenging life circumstances. Interest in PTG has increased in cancer survivorship care; however, little is known about PTG among stomach cancer survivors. This study aimed to examine the prevalence and correlates of PTG, and to identify relationships between PTG and health-related quality of life (HRQOL). METHODS Cross-sectional descriptive design. In total, 122 stomach cancer survivors were recruited from one university hospital in South Korea. Measurements included the Korean version of the Post-traumatic Growth Inventory and the Functional Assessment of Cancer Therapy--General Population. RESULTS Over half (53.3%) of the participants experienced moderate to high levels of PTG. 'Change of self-perception' was the most common growth domain, followed by 'relating to others', 'new possibilities' and 'spiritual change'. Older age, low socio-economic status (i.e. low education level and low monthly income) and lack of religion were associated with lower levels of PTG. Survivors with higher levels of PTG had better social/family well-being (P < 0.001) and better functional well-being (P < 0.001). CONCLUSIONS Psychological interventions to enhance PTG may have a positive effect on impaired HRQOL among stomach cancer survivors.
Collapse
Affiliation(s)
- Bo Yun Sim
- College of Nursing, Pusan National University, Busan, Republic of Korea
| | - Young Whee Lee
- Department of Nursing, Inha University, Incheon, Republic of Korea
| | - Hwasoon Kim
- Department of Nursing, Inha University, Incheon, Republic of Korea
| | - Soo Hyun Kim
- Department of Nursing, Inha University, Incheon, Republic of Korea.
| |
Collapse
|
30
|
Santoro R, Ettorre GM, Santoro E. Subtotal gastrectomy for gastric cancer. World J Gastroenterol 2014; 20:13667-13680. [PMID: 25320505 PMCID: PMC4194551 DOI: 10.3748/wjg.v20.i38.13667] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Revised: 06/10/2014] [Accepted: 06/26/2014] [Indexed: 02/06/2023] Open
Abstract
Although a steady decline in the incidence and mortality rates of gastric carcinoma has been observed in the last century worldwide, the absolute number of new cases/year is increasing because of the aging of the population. So far, surgical resection with curative intent has been the only treatment providing hope for cure; therefore, gastric cancer surgery has become a specialized field in digestive surgery. Gastrectomy with lymph node (LN) dissection for cancer patients remains a challenging procedure which requires skilled, well-trained surgeons who are very familiar with the fast-evolving oncological principles of gastric cancer surgery. As a matter of fact, the extent of gastric resection and LN dissection depends on the size of the disease and gastric cancer surgery has become a patient and “disease-tailored” surgery, ranging from endoscopic resection to laparoscopic assisted gastrectomy and conventional extended multivisceral resections. LN metastases are the most important prognostic factor in patients that undergo curative resection. LN dissection remains the most challenging part of the operation due to the location of LN stations around major retroperitoneal vessels and adjacent organs, which are not routinely included in the resected specimen and need to be preserved in order to avoid dangerous intra- and postoperative complications. Hence, the surgeon is the most important non-TMN prognostic factor in gastric cancer. Subtotal gastrectomy is the treatment of choice for middle and distal-third gastric cancer as it provides similar survival rates and better functional outcome compared to total gastrectomy, especially in early-stage disease with favorable prognosis. Nonetheless, the resection range for middle-third gastric cancer cases and the extent of LN dissection at early stages remains controversial. Due to the necessity of a more extended procedure at advanced stages and the trend for more conservative treatments in early gastric cancer, the indication for conventional subtotal gastrectomy depends on multiple variables. This review aims to clarify and define the actual landmarks of this procedure and the role it plays compared to the whole range of new and old treatment methods.
Collapse
|
31
|
Hwang IC, Yun YH, Kim YW, Ryu KW, Kim YA, Kim S, Bae JM, Noh JH, Sohn TS. Factors related to clinically relevant fatigue in disease-free stomach cancer survivors and expectation–outcome consistency. Support Care Cancer 2014; 22:1453-60. [DOI: 10.1007/s00520-013-2110-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 12/25/2013] [Indexed: 12/17/2022]
|
32
|
Han KH, Hwang IC, Kim S, Bae JM, Kim YW, Ryu KW, Lee JH, Noh JH, Sohn TS, Shin DW, Yun YH. Factors associated with depression in disease-free stomach cancer survivors. J Pain Symptom Manage 2013; 46:511-22. [PMID: 23489829 DOI: 10.1016/j.jpainsymman.2012.10.234] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2011] [Revised: 10/13/2012] [Accepted: 10/23/2012] [Indexed: 12/16/2022]
Abstract
CONTEXT Depression in cancer survivors affects the rest of their lives in many ways. OBJECTIVES To estimate the prevalence of depression and identify associated factors in disease-free stomach cancer survivors. METHODS We enrolled 391 stomach cancer survivors who had been disease-free for at least one year after surgery from the cancer registries of two hospitals in Korea. Stomach cancer survivors were mailed a survey that included the Beck Depression Inventory, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30, and the associated stomach module, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Stomach Cancer Module 22. RESULTS Forty-four percent of survivors suffered from depression, and more women (49%) than men (42%) had high depression scores (Beck Depression Inventory >13). In multiple logistic regression analysis, lower income (odds ratio [OR] 2.49; 95% CI 1.64-3.78), problems with care before treatment (OR 1.92; 95% CI 1.23-2.98), body image change (OR 2.23; 95% CI 1.41-3.53), and symptoms of fatigue (OR 3.11; 95% CI 1.49-6.52), dyspnea (OR 2.57; 95% CI 1.48-4.45), or insomnia (OR 4.51; 95% CI 1.88-10.83) were associated with depression. CONCLUSION The prevalence of depression was high in stomach cancer survivors even after the completion of treatment, especially among those with problems amenable to treatment, and we identified the associated factors. We suggest that stomach cancer survivors should be screened for depression after the end of treatment.
Collapse
Affiliation(s)
- Kyung Hee Han
- Division of Cancer Control and Hospital, National Cancer Center, Goyang, Korea
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Abstract
BACKGROUND Gastrectomy remains a major operation with potential for significant deterioration in patients' health-related quality of life (QOL). This study assessed differences in QOL among patients after distal (DG), proximal (PG), or total (TG) gastrectomy. METHODS We prospectively enrolled patients undergoing gastrectomy at our institution between 2002 and 2007. Participants completed the European Organization for Research and Treatment of Cancer cancer (QLQ-C30) and gastric (QLQ-STO22) questionnaires preoperatively and at 5 postoperative intervals up to 18 months. We compared changes from baseline in patients based on extent of resection (proximal, distal, or total) using generalized linear models, adjusting for age, stage of disease, and (neo)adjuvant therapy. We converted QOL raw scores to reflect the proportion of patients with clinically significant deterioration based on the minimal important difference. RESULTS We included 134 patients: 82 DG, 16 PG, and 36 TG. In the immediate postoperative period, 55% of patients suffered significant impairment in their global QOL. This improved in most patients by 6 months, although 20% to 35% continued to have substantially worse QOL than before surgery. Patients who underwent PG suffered from significantly more clinical reflux [70% vs 35% (DG), 40% (TG)], nausea/vomiting (60% vs 25%, 30%), and global QOL impairment (60% vs 30%, 30%) than patients who underwent DG or TG, whose QOL scores were similar. These differences persisted up to 18 months postoperatively. CONCLUSIONS Surgeons should discuss expectations of QOL impairment with their patients before gastrectomy and reassure them that most symptoms resolve by 6 months after operation. Patients who undergo PG suffer from worse QOL impairment than patients who undergo DG or TG.
Collapse
|
34
|
Long-term nutrition intervention following major upper gastrointestinal surgery: a prospective randomized controlled trial. Eur J Clin Nutr 2013; 67:324-9. [PMID: 23388664 DOI: 10.1038/ejcn.2013.17] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND/OBJECTIVES Nutritional status has been shown to affect quality of life, tolerance of future treatments and survival in people having undergone major upper gastrointestinal surgery. The objective of this trial was to assess the impact of intense individualized dietary advice following major upper gastrointestinal surgery on nutritional status, dietary intake, gastrointestinal symptoms and quality of life, compared to the current usual care. SUBJECTS/METHODS On discharge from hospital, people having had major upper gastrointestinal surgery were randomized to have dietetic follow-up fortnightly for 6 months or to a control group. Data collection was conducted at baseline, and at 1, 3 and 6 months. RESULTS Twenty-seven people were randomized to either the intervention or control group. There was a small but non-significant difference in percent weight loss in the intervention (-0.8 ± 8.8) compared to the control group (-2.7 ± 9.7) at 6 months. There were no other differences between the two groups. CONCLUSIONS This small study did not demonstrate that intense individualized dietary advice leads to improvements in nutritional status and quality of life for people having had major upper gastrointestinal surgery. The study does highlight that this group is at high nutritional risk, and does support the need for a larger multicentre study.
Collapse
|
35
|
Changes of quality of life in gastric cancer patients after curative resection: a longitudinal cohort study in Korea. Ann Surg 2013; 256:1008-13. [PMID: 23154395 DOI: 10.1097/sla.0b013e31827661c9] [Citation(s) in RCA: 102] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Little is known about how quality of life (QOL) changes over time after gastrectomy. We prospectively examined changes of QOL in Korean patients with gastric cancer after curative resection. BACKGROUND As early detection and improved treatment have led to higher survival rates and an increasing number of long-term survivors, the importance of QOL has increased. METHODS Patients newly diagnosed with gastric cancer, who were expected to undergo curative resection, were studied. QOL was assessed, using the European Organization for Research and Treatment of Cancer QLQ-C30 and its gastric module QLQ-STO22, before and after 3 and 12 months of gastrectomy. RESULTS In total, 465 patients were included in the study, and 377 and 88 patients underwent subtotal gastrectomy and total gastrectomy, respectively. For most of the functional or symptom scales, the mean score deteriorated at 3 months and generally improved during follow-up period. Patients with total gastrectomy had more functional and symptomatic problems related to QOL than those with subtotal gastrectomy during the follow-up. For both groups, there were temporal, unrecovered, improved, and unchanged problems in QOL. Fatigue; digestive symptoms such as diarrhea, dysphagia, and eating restrictions; body image disturbance; and cognitive functioning were the representative unrecovered problems, which persisted at 12 months after surgery. CONCLUSIONS Our findings show that there are various functional and symptomatic problems, which health care providers need to manage during the postsurgical period. We need to continuously address fatigue, diarrhea, dysphagia, eating restrictions, body image disturbance, and cognitive functioning. In addition, it would be necessary to inform patients about possible QOL outcomes while they are receiving information about surgery and signing informed consent for surgery.
Collapse
|
36
|
Health-Related Quality of Life in Disease-Free Survivors of Surgically Treated Lung Cancer Compared With the General Population. Ann Surg 2012; 255:1000-7. [DOI: 10.1097/sla.0b013e31824f1e9e] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
|
37
|
Willingham FF, Garud SS, Davis SS, Lewis MM, Maithel SK, Kooby DA. Human hybrid endoscopic and laparoscopic management of mass lesions of the foregut (with video). Gastrointest Endosc 2012; 75:905-12. [PMID: 22281108 DOI: 10.1016/j.gie.2011.11.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Accepted: 11/17/2011] [Indexed: 12/29/2022]
Affiliation(s)
- Field F Willingham
- Division of Digestive Diseases, Emory University School of Medicine, Atlanta, Georgia 30322, USA
| | | | | | | | | | | |
Collapse
|
38
|
Carey S, Ferrie S, Young J, Allman-Farinelli M. Long-term nutrition support in gastrointestinal disease—A systematic review of the evidence. Nutrition 2012; 28:4-8. [DOI: 10.1016/j.nut.2011.07.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2010] [Revised: 07/04/2011] [Accepted: 07/04/2011] [Indexed: 01/05/2023]
|
39
|
Munene G, Francis W, Garland SN, Pelletier G, Mack LA, Bathe OF. The quality of life trajectory of resected gastric cancer. J Surg Oncol 2011; 105:337-41. [PMID: 22095440 DOI: 10.1002/jso.22139] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Accepted: 10/19/2011] [Indexed: 01/05/2023]
Abstract
BACKGROUND Few studies describe quality of life (QoL) outcomes following gastrectomy for gastric cancer using a validated instrument. The gastric cancer module for the Functional Assessment of Cancer Therapy system of QoL measurement tools (FACT-Ga) was utilized to determine the changes in QoL following gastrectomy, and during the disease course. METHODS In 43 patients undergoing gastrectomy for gastric cancer, outcome such as complications, recurrence, and survival were annotated. Karnofsky performance status (KPS) and QoL were determined preoperatively and at each follow-up visit. RESULTS Nineteen (44%) patients and 24 (56%) patients underwent partial gastrectomy (PG) and total gastrectomy (TG), respectively. Complications occurred in 30%, and one mortality (2.3%) occurred. Median survival was 23 months. KPS, FACT-G, and FACT-Ga scores all decreased after surgery, and normalized by 6 months. There was no significant difference in QoL in patients who had a PG or TG, although the type of gastrectomy did affect KPS. QoL dropped on average 4.4 ± 3.6 months prior to death. CONCLUSIONS Surgery adversely affects QoL for up to 6 months. Thereafter, QoL mirrors changes in disease status. More studies are required to document the QoL cost-benefit ratio in gastric cancer, which often is accompanied by short survival benefits.
Collapse
Affiliation(s)
- Gitonga Munene
- Department of Surgery, University of Calgary, AB, Canada
| | | | | | | | | | | |
Collapse
|
40
|
Dorcaratto D, Grande L, Ramón JM, Pera M. [Quality of life of patients with cancer of the oesophagus and stomach]. Cir Esp 2011; 89:635-44. [PMID: 21907976 DOI: 10.1016/j.ciresp.2011.07.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2011] [Accepted: 06/27/2011] [Indexed: 12/17/2022]
Abstract
The study of the health related quality of life in patients with digestive tract cancer, and particularly in those with tumours of the oesophagus and stomach, provides useful information for selecting the most suitable therapeutic option. It may also be used to predict the impact of the disease and its possible treatments on the physical, emotional and social condition of the patient. Various sensitive and reliable tools have been developed over the past decades that are capable of measuring the quality of life of patients; the use of questionnaires has made it easier to exchange information between the patient and the doctor. The pre- and post-operative variations in the quality of life in patients with oesophageal-gastric cancer are of prognostic value on the outcome of the disease. For all these reasons, the health related quality of life is currently considered, along with disease free survival and absence of recurrences, one of the most important parameters in order to assess the impact on the patients of a particular oncological treatment. The aim of this article is to review the role of the health related quality of life assessment, as well as the various tools which are available to measure it in patients with oesophageal-gastric cancer.
Collapse
Affiliation(s)
- Dimitri Dorcaratto
- Sección de Cirugía Gastrointestinal, Servicio de Cirugía General y Digestiva, Hospital Universitario del Mar, Institut de Recerca IMIM-Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | | | | | | |
Collapse
|
41
|
Kwon IG, Ryu E, Noh GO, Sung YH. Health-related quality of life in cancer patients between baseline and a three-year follow-up. Eur J Oncol Nurs 2011; 16:131-6. [PMID: 21767987 DOI: 10.1016/j.ejon.2011.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2010] [Revised: 05/16/2011] [Accepted: 05/20/2011] [Indexed: 11/12/2022]
Abstract
PURPOSE The aim of the study was to identify health-related quality of life (QOL) in persons diagnosed with cancer and to determine differences between the QOL over a 3-year period. METHODS We investigated the QOL in cancer patients at baseline and 3 years later using the EORTC QLQ-C30 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30) and the ECOG (Eastern Cooperative Oncology Group) Performance Status. Initially 216 participants (85 women, 131 men) were enrolled, and at the 3-year follow-up there were 126 (52 women, 74 men). RESULTS Scores on the function and symptom scales changed significantly between the baseline and the 3-year follow-up. Physical, role, and social functions improved, whereas problems with constipation worsened. The global QOL of the participants at the 3-year follow-up was lower than that of baseline, but it was not statistically significant. The QOL in cancer patients improved from the baseline to the 3-year follow-up. CONCLUSION The results could serve as a guideline for nurses interpreting the perspective of QOL in their own groups of patients, and improve the understanding of the significance of mean QOL scores and develop nursing interventions in the future.
Collapse
Affiliation(s)
- In Gak Kwon
- Department of Clinical Nursing Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Gangnam-Gu, Seoul 135-710, Republic of Korea.
| | | | | | | |
Collapse
|
42
|
Systematic review: quality of life after treatment for upper gastrointestinal cancer. Curr Opin Support Palliat Care 2011; 5:37-46. [PMID: 21326002 DOI: 10.1097/spc.0b013e3283436ecb] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE OF REVIEW The aim of this systematic review is to scrutinize and summarize the design, conduct and reporting standards of articles recently published describing health-related quality of life (HRQL) outcomes of treatment of upper gastrointestinal cancer. RECENT FINDINGS Some 2312 abstracts were published between January and July 2009 and initial elimination of papers reduced this number to 22 articles. Of these, 17 were judged to have robust HRQL methodology, but a further seven were excluded due to a high risk of bias in the study design. Ten articles (four randomized trials) were finally included in the review. Studies in curative treatments for oesophagogastric cancer show that surgery and chemoradiation therapy has a major short-term detrimental effect on HRQL, but recovery occurs within 6 months in long-term survivors but those not achieving a survival benefit report very poor HRQL. In advanced oesophageal cancer, 18 mm self-expandable metal stents and nonstent therapies lead to better short-term HRQL scores than nonexpandable stents and are the recommended standard of care. A small survival advantage and improved HRQL is conferred by adjuvant and palliative gemcitabine chemotherapy in patients with pancreatic cancer. SUMMARY This review identified few well-designed studies that also included a robust assessment of HRQL. High-quality trials with reliable HRQL methods are required for outcomes to inform health policy and clinical decision-making.
Collapse
|
43
|
Lee SS, Chung HY, Yu W. Quality of life of long-term survivors after a distal subtotal gastrectomy. Cancer Res Treat 2010; 42:130-4. [PMID: 20948917 PMCID: PMC2953775 DOI: 10.4143/crt.2010.42.3.130] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2010] [Accepted: 03/31/2010] [Indexed: 12/23/2022] Open
Abstract
PURPOSE The aim of this study was to investigate the impact of a distal subtotal gastrectomy on the quality of life (QoL). MATERIALS AND METHODS The QoL data of 126 patients were obtained on their 5th annual follow-up visit after a curative distal subtotal gastrectomy for gastric cancer (Group A). The QoL data of 130 age- and gender-adjusted healthy population were obtained from the individuals who visited the health screening center for a medical check-up (Group B). There were 42 women and 84 men in the study group and their mean age was 56.0±11.1 years. QoL was assessed using the Korean versions of the European Organization for Research and Treatment of Cancer (EORTC) QoL Questionnaire Core 30 (QLQ-C30) and QLQ-STO22. RESULTS The EORTC QLQ-C30 global health status and QoL scores of Group A and Group B were 63.9±22.7 and 61.3±22.1, respectively (p=0.361). Group A revealed a better score for emotional functioning (84.1±16.1 and 75.2±21.4, respectively; p<0.001), cognitive functioning (82.0±16.4 and 75.0±21.4, respectively; p=0.004) and fatigue (27.7±20.8 and 33.8±23.2, respectively; p=0.028). However, Group A revealed a worse score for nausea and vomiting (14.8±20.0 and 10.2±16.0, respectively; p=0.042), financial difficulties (14.8±22.9 and 7.1±16.1, respectively; p=0.002), reflux (16.7±17.7 and 10.1±17.0, respectively; p=0.003), eating restrictions (13.6±15.2 and 6.6±10.2, respectively; p<0.001) and body image (23.3±25.4 and 16.2±24.6, respectively; p=0.023). CONCLUSION The QoL of long-term survivors after a distal subtotal gastrectomy is still influenced by the surgery itself even though they are considered to be free of disease.
Collapse
Affiliation(s)
- Seung Soo Lee
- Department of Surgery, Kyungpook National University Hospital, Daegu, Korea
| | - Ho Young Chung
- Department of Surgery, Kyungpook National University Hospital, Daegu, Korea
| | - Wansik Yu
- Department of Surgery, Kyungpook National University Hospital, Daegu, Korea
| |
Collapse
|
44
|
Zheng J, Zheng J, Zheng PY. [Application of quality of life scale in evaluating the efficacy of gastric cancer treatment]. ACTA ACUST UNITED AC 2010; 6:304-10. [PMID: 18334154 DOI: 10.3736/jcim20080317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Jun Zheng
- Department of Oncology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
| | | | | |
Collapse
|
45
|
Sadighi S, Montazeri A, Sedighi Z, Mohagheghi MA, Froutan H. Quality of life in patients with gastric cancer: translation and psychometric evaluation of the Iranian version of EORTC QLQ-STO22. BMC Cancer 2009; 9:305. [PMID: 19715606 PMCID: PMC2741487 DOI: 10.1186/1471-2407-9-305] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2009] [Accepted: 08/28/2009] [Indexed: 12/23/2022] Open
Abstract
Background Disease and treatment related events, can adversely affect the quality of life of patients with cancer. The purpose of this study was to translate and validate a gastric cancer specific health related quality of life questionnaire (EORTC QLQ-STO22) for Iranian patients suffering from gastric cancer. Methods Forward-backward procedure was applied to translate the English language version of the EORTC QLQ-STO22 into Persian (Iranian language). Then, the questionnaire and the EORTC core quality of life instrument (QLQ-C30) were administered to a sample of patients with confirmed diagnosis of gastric cancer. All patients filled in questionnaires before and after one month of treatment. Patients were divided into two groups based on intension of treatment (curative vs. palliative). Reliability and validity of the module was tested by internal consistency and known group comparisons, respectively. Results In all, 105 patients were entered into the study. Cronbach's alpha for multi-item scales (to test reliability) ranged from 0.54 to 0.87. The questionnaire discriminated well between clinically distinct subgroups of patients both before and after treatment lending support to its convergent and clinical validity. Conclusion Overall, the Iranian version of the EORTC QLQ-STO22 demonstrated a good reliability and clinical validity to support its use in combination with core questionnaire in outcome studies of gastric cancer in Iran. However, using the QLQ-STO22 in a wide range of Iranian patients with gastric cancer should allow further confirmation for its psychometric properties.
Collapse
Affiliation(s)
- Sanamber Sadighi
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | | | | | | | | |
Collapse
|
46
|
Shin DW, Jung KT, Kim S, Bae JM, Kim YW, Ryu KW, Lee JH, Noh JH, Sohn TS, Yun YH. Impact of supplementary private health insurance on stomach cancer care in Korea: a cross-sectional study. BMC Health Serv Res 2009; 9:133. [PMID: 19643032 PMCID: PMC2726135 DOI: 10.1186/1472-6963-9-133] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2009] [Accepted: 07/31/2009] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Korea achieved universal health insurance coverage in only 12 years; however, insufficient government funding has resulted in high out-of-pocket payments and, in turn, a demand for supplementary private health insurance (PHI). Supplementary PHI provides a fixed amount of benefits in the event of critical illness (e.g., cancer or stroke), surgery, or hospitalization. In this study, we tried to identify factors that influence the decision to purchase supplementary PHI and investigate the impacts of PHI on various aspects of cancer care. METHODS In a cross-sectional study of 391 patients with gastric cancer, we collected data on demographic and clinical variables, coverage by PHI at the time of diagnosis, and patients' cancer care experiences from surgery databases and patient questionnaires. Two separate multivariate logistic regression models were used 1) to determine whether various sociodemographic and clinical variables influence the purchase of supplementary PHI, and 2) to determine if there is a difference in various outcome measures between individuals with and without PHI. RESULTS We studied 187 subjects (49.6%) who were covered under PHI at the time of diagnosis. Subjects who purchased PHI tended to be younger (aOR = 5.01, 95% C.I. = 2.05 - 12.24), and more educated (aOR = 2.67, 95% C.I. = 1.04 - 6.86). Supplementary PHI coverage was significantly associated with financial independence (aOR = 2.07, 95% CI = 1.19 - 3.61), but not with other aspects of cancer care, such as access to healthcare, quality of care, communication and patient autonomy. CONCLUSION Our findings demonstrate that supplementary PHI neither serves as a safety net for vulnerable patients nor improves cancer care experience, except for maintaining the financial independence of beneficiaries.
Collapse
Affiliation(s)
- Dong Wook Shin
- National Cancer Control Research Institute & Hospital, National Cancer Center, Goyang, Gyeonggi, Korea
| | - Kee-Taig Jung
- Department of Health Services Management, Kyung Hee University, Seoul, Korea
| | - Sung Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea
| | - Jae-Moon Bae
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea
| | - Young-Woo Kim
- National Cancer Control Research Institute & Hospital, National Cancer Center, Goyang, Gyeonggi, Korea
| | - Keun Won Ryu
- National Cancer Control Research Institute & Hospital, National Cancer Center, Goyang, Gyeonggi, Korea
| | - Jun Ho Lee
- National Cancer Control Research Institute & Hospital, National Cancer Center, Goyang, Gyeonggi, Korea
| | - Jae-Hyung Noh
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea
| | - Tae-Sung Sohn
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea
| | - Young Ho Yun
- National Cancer Control Research Institute & Hospital, National Cancer Center, Goyang, Gyeonggi, Korea
| |
Collapse
|
47
|
Jung HJ, Lee JH, Ryu KW, Lee JY, Kim CG, Choi IJ, Kim YW, Bae JM. The influence of reconstruction methods on food retention phenomenon in the remnant stomach after a subtotal gastrectomy. J Surg Oncol 2008; 98:11-4. [PMID: 18461561 DOI: 10.1002/jso.21076] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND OBJECTIVES Food retention and bile reflux has been frequently observed in gastric cancer patients following a subtotal gastrectomy. The aim of this study was to determine whether reconstruction methods after the distal subtotal gastrectomy influenced the degree of food residue and bile reflux. METHODS The prospectively collected data was reviewed retrospectively for 522 patients with early gastric cancer who had undertaken a follow-up endoscopic examination after a distal subtotal gastrectomy between 2003 and 2006. RESULTS The incidence of food retention was 55.5%, 31.9%, and 20.9% at 3, 12, and 24 months after distal subtotal gastrectomy, respectively. The food residue score was higher in the Billroth I (stapling) group than the Billroth II (hand sewing) group at 3 months after surgery (P = 0.006). The incidence of bile reflux was higher in the Billroth II group than in the Billroth I group at 12 and 24 months after surgery (P < 0.001, P = 0.002, respectively). No significant association was found between the food retention and body weight changes. CONCLUSIONS Food retention was detected in lots of patients after subtotal gastrectomy and the reconstructive methods after subtotal gastrectomy was not relevant to food retention.
Collapse
Affiliation(s)
- Hyung Joong Jung
- Center for Gastric Cancer, National Cancer Center, Ilsandong-gu, Goyang-si, Gyeonggi-do, South Korea
| | | | | | | | | | | | | | | |
Collapse
|
48
|
Lee MK, Lee KM, Bae JM, Kim S, Kim YW, Ryu KW, Lee JH, Noh JH, Sohn TS, Hong SK, Yun YH. Employment status and work-related difficulties in stomach cancer survivors compared with the general population. Br J Cancer 2008; 98:708-15. [PMID: 18283298 PMCID: PMC2259191 DOI: 10.1038/sj.bjc.6604236] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Little was known about work situation and work-related difficulties, including housework after stomach cancer diagnosis. We aimed to compare employment status and work-related difficulties between stomach cancer survivors and the general population. We enrolled 408 stomach cancer survivors from two hospitals 28 months after diagnosis and 994 representative volunteers from the general population from 15 geographic districts. Working was defined as being employed (including self-employed) and nonworking as being retired or a homemaker. Nonworking was significantly higher among stomach cancer survivors (46.6%) than in the general population (36.5%). Compared with the general population, the survivors had more fatigue in performing both housework (adjusted odds ratio (aOR)=2.08; 95% confidence interval (95% CI)=1.01-4.29) and gainful work (aOR=4.02; 2.55-6.33). More cancer survivors had reduced working hours (aOR=1.42; 95% CI=4.60-28.35) and reduced work-related ability (aOR=6.11; 95% CI=3.64-10.27) than did the general population. The association of nonworking with older age and being female was significantly more positive for survivors than for the general population. Among survivors, poorer Eastern Cooperation Oncology Group Performance Status and receiving total gastrectomy were positively associated with nonworking. Stomach cancer survivors experienced more difficulties in both housework and gainful employment than did the general population. Our findings on stomach cancer survivors' work-related difficulties and the predictors of nonworking will help physicians guide patients towards more realistic postsurgical employment plans.
Collapse
Affiliation(s)
- M K Lee
- Research Institute and Hospital, National Cancer Center, 809 Madu dong, Ilsan gu, Goyang si, Gyeonggi do 411-769, Korea
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Conroy T, Uwer L, Deblock M. Health-related quality-of-life assessment in gastrointestinal cancer: are results relevant for clinical practice? Curr Opin Oncol 2007; 19:401-6. [PMID: 17545808 DOI: 10.1097/cco.0b013e32816f7704] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
PURPOSE OF REVIEW Health-related quality-of-life studies are now recognized as critical to understand the burden of disease and treatments on patients' well being. Significant advances have been recently achieved in gastrointestinal cancers, including the development and clinical use of new robust quality-of-life instruments. We review recent literature to evaluate whether quality-of-life assessment contributes to optimal patient information and helps treatment choices. RECENT FINDINGS Treatments of gastrointestinal cancers have changed in the last few years with increasing use of multimodal therapies and advances in surgical techniques, especially for low-lying rectal cancers. Concurrent to the development of sphincter-saving procedures, however, the long-term consequences of a permanent stoma on quality of life have been debated. Results of new palliative treatments should also be considered looking at preservation or improvement of quality of life and not only prolongation of life. SUMMARY Gastrointestinal malignancies impact strongly on patient quality of life due to the aggressiveness of the treatments. Short-term negative effects of surgery and specific deficits in survivors were recently described in gastrointestinal cancers. Baseline quality-of-life data predict length of survival in hepatocarcinoma and metastatic colorectal cancer. Generally, quality-of-life results help to fully inform the patients of the advantages or disadvantages of therapeutic options, including adjuvant and palliative treatments.
Collapse
Affiliation(s)
- Thierry Conroy
- Department of Medical Oncology, Alexis Vautrin Centre and EA 4003, Nancy-University, Vandoeuvre-lès-Nancy, France.
| | | | | |
Collapse
|
50
|
Kim S, Bae JM, Kim YW, Ryu KW, Lee JH, Noh JH, Sohn TS, Hong SK, Lee MK, Park SM, Yun YH. Self-reported experience and outcomes of care among stomach cancer patients at a median follow-up time of 27 months from diagnosis. Support Care Cancer 2007; 16:831-9. [PMID: 17909862 DOI: 10.1007/s00520-007-0340-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2007] [Accepted: 09/18/2007] [Indexed: 12/23/2022]
Abstract
GOALS OF WORK We aimed to identify clinical experiences associated with outcomes of care among stomach cancer patients. MATERIALS AND METHODS Four hundred thirty-two patients who had a diagnosis of stage I-III stomach cancer from 2001 through 2002 from two hospitals in South Korea responded to a survey questionnaire including sociodemographic and clinical data, information about care experiences, satisfaction with care, and quality of life (QOL). MAIN RESULTS Involvement in decision making [adjusted odds ratio (aOR) = 1.81; 95% confidence interval (CI), 1.13 to 2.89] and reflection of patients' opinions in treatment decisions (aOR = 2.54; 95% CI, 1.65 to 3.93) were associated with decision satisfaction. The factors associated with willingness to choose the same treatment over again were involvement in decision making (aOR = 2.37; 95% CI, 1.53 to 3.68) and no treatment toxicity (aOR = 0.50; 95% CI, 0.29 to 0.87). Involvement in decision making, reflection of patients' opinions in treatment decisions, and treatment toxicity were associated with some functioning subscales of QOL (p < 0.05). Regular follow-up, however, was associated with poor social functioning. CONCLUSIONS Quality improvement efforts for stomach cancer patients should focus not only on the quality of primary tumor therapy but also on how patients experience their care, such as patient-centered decision making, experience of treatment toxicity, and regular follow-up.
Collapse
Affiliation(s)
- Sung Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|