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Changes of Quality of Life in Gastric Cancer Patients After Curative Resection: A Longitudinal Cohort Study in Korea

Kim, Ae Ran MSN†,‡; Cho, Juhee PhD§,∥,¶; Hsu, Yea-Jen MSN#; Choi, Min Gew MD, PhD*,‡; Noh, Jae Hyung MD, PhD*,‡; Sohn, Tae Sung MD, PhD*,‡; Bae, Jae Moon MD, PhD*,‡; Yun, Young Ho MD, PhD**; Kim, Sung MD, PhD*,‡

doi: 10.1097/SLA.0b013e31827661c9
Original Articles

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.

This study examined changes in quality of life (QOL) in 465 Korean patients with gastric cancer after curative resection. For most of the functional or symptom scales, the mean score deteriorated at 3 months and generally improved during the follow-up period. Patients with total gastrectomy experienced more functional and symptomatic problems related to QOL than those with subtotal gastrectomy during the follow-up.

Department of *Surgery

Department of Nursing

Stomach Cancer Center

§Cancer Education Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Department of Health, Behavior and Society

Department of Epidemiology

#Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA

**Department of Medicine, Seoul National University College of Medicine, Seoul, Korea.

Reprints: Sung Kim, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, Korea. E-mail: sungkimm@skku.edu.

Disclosure: The authors declare no conflicts of interest.

© 2012 Lippincott Williams & Wilkins, Inc.