Health-related quality of life and survival in the 2years after surgery for gastric cancer

Avery, K.; Hughes, R.; McNair, A.; Alderson, D.; Barham, P.; Blazeby, J.

doi:10.1016/j.ejso.2009.09.008

« Previous Next »European Journal of Surgical Oncology
Volume 36, Issue 2 , Pages 148-154, February 2010

Health-related quality of life and survival in the 2years after surgery for gastric cancer

K. Avery
- Department of Social Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Clifton, Bristol BS8 2PS, UK
R. Hughes
- Department of Social Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Clifton, Bristol BS8 2PS, UK
A. McNair
- Department of Social Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Clifton, Bristol BS8 2PS, UK
- University Hospitals Bristol NHS Foundation Trust, Bristol BS2 8HW, UK
D. Alderson
- Clinical Sciences at South Bristol, Bristol Royal Infirmary, Bristol BS2 8HW, UK
P. Barham
- University Hospitals Bristol NHS Foundation Trust, Bristol BS2 8HW, UK
J. Blazeby
- Department of Social Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Clifton, Bristol BS8 2PS, UK
- University Hospitals Bristol NHS Foundation Trust, Bristol BS2 8HW, UK
- Clinical Sciences at South Bristol, Bristol Royal Infirmary, Bristol BS2 8HW, UK
- Corresponding author. Department of Social Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Clifton, Bristol BS8 2PS, UK. Tel.: +44 117 928 7231; fax: +44 117 925 2736.

Accepted 21 September 2009.

Abstract

Background

This prospective study examined health-related quality of life (HRQL) and survival in patients with potentially curable gastric cancer.

Methods

Consecutive patients (n=58) selected for curative surgery completed a validated questionnaire (EORTC QLQ-C30) and site-specific module (QLQ-STO22) before surgery and regularly for 2years afterwards. Changes of 10 or more points on a 0–100 scale were considered clinically significant.

Results

Some 30 patients were alive after 2years (52%). In the first 3months after surgery, HRQL was significantly reduced across all dimensions except emotional and cognitive functioning (mean reduction of 10 or more points). Functional aspects of HRQL recovered by 6months in patients who subsequently were alive at 2years, although at least a third of patients experienced specific symptoms, even 6months after surgery, especially diarrhoea. For those dying within 2years, some postoperative functional HRQL recovery occurred, but many symptoms were common.

Conclusions

Potentially curative gastrectomy for cancer has a detrimental impact on HRQL that mostly recovers in patients surviving some 2years. Patients who die within 2years may experience limited postoperative recovery. It is recommended that patients receive HRQL information about the outcomes of surgery for gastric cancer.

Keywords: Gastrectomy, Quality of life, Decision-making, Informed consent