Cancer Res Treat.  2018 Jul;50(3):852-860. 10.4143/crt.2017.080.

Impact of Body Mass Index on the Quality of Life after Total Gastrectomy for Gastric Cancer

• Park KB
• Park JY
• Lee SS
• Kwon OK
• Chung HY
• Yu W

• KMID: 2417874
• DOI: http://doi.org/10.4143/crt.2017.080

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.

Keyword

Quality of life; Stomach neoplasms; Gastrectomy; Body mass index

MeSH Terms

Appetite
Body Image
Body Mass Index*
Constipation
Deglutition Disorders
Eating
Gastrectomy*
Global Health
Humans
Nausea
Nutritional Support
Quality of Life*
Stomach Neoplasms*
Vomiting
Weights and Measures

Figure

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  Fig. 1. Body mass index shift after total gastrectomy.

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  Fig. 2. Changes in the quality of life (QoL) according to body mass index shifts 1 year after total gastrectomy, as assessed by the global health status/QoL and functional scales of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30. GH, global health status; PF2, physical functioning; RF2, role functioning; EF, emotional functioning; CF, cognitive functioning; SF, social functioning.

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  Fig. 3. Changes in the quality of life according to body mass index shifts 1 year after total gastrectomy, as assessed by symptom scales/items of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30. FA, fatigue; NV, nausea and vomiting; PA, pain; DY, dyspnea; SL, insomnia; AP, appetite loss; CO, constipation; DI, diarrhea; FI, financial difficulties. *p < 0.05.

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  Fig. 4. Changes in the quality of life according to body mass index shifts 1 year after total gastrectomy, as assessed by symptom scales/items of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire STO22. XDG, dysphagia; Xpain, pain; XRflx, reflux symptoms; XEatR, eating restrictions; Anx, anxiety; DM, having a dry mouth; T, taste; BI, body image; HL, hair loss. *p < 0.05.

Reference

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