J Gastric Cancer.
2022 Jul;22(3):235-247. 10.5230/jgc.2022.22.e23.
Impact of Tumor Location on the Quality of Life of Patients Undergoing Total or Proximal Gastrectomy
- Fujisaki M
1 - Nomura T2
- Yamashita H3
- Uenosono Y4
- Fukunaga T5
- Otsuji E6
- Takahashi M7
- Matsumoto H8
- Oshio A9
- Nakada K10
- Affiliations
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- 1Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
- 2Department of Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan
- 3Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan
- 4Department of Digestive Surgery, Imamura General Hospital, Kagoshima, Japan
- 5Department of Gastroenterology and Minimally Invasive Surgery, Juntendo University School of Medicine, Tokyo, Japan
- 6Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
- 7Department of Surgery, JCHO Sapporo Hokushin Hospital, Sapporo, Japan
- 8Mitsugi General Hospital, Hiroshima, Japan
- 9Faculty of Letters, Arts and Sciences, Waseda University, Tokyo, Japan
- 10Department of Laboratory Medicine, The Jikei University School of Medicine, Tokyo, Japan
- KMID: 2535101
- DOI: http://doi.org/10.5230/jgc.2022.22.e23
Abstract
- Purpose
Most studies have investigated the differences in postgastrectomy quality of life (QOL) based on the surgical procedure or reconstruction method adopted; only a few studies have compared QOL based on tumor location. This large-scale study aims to investigate the differences in QOL between patients with esophagogastric junction cancer (EGJC) and those with upper third gastric cancer (UGC) undergoing the same gastrectomy procedure to evaluate the impact of tumor location on postoperative QOL.
Methods
The Postgastrectomy Syndrome Assessment Scale-45 (PGSAS-45) questionnaire was distributed in 70 institutions to 2,364 patients who underwent gastrectomy for EGJC or UGC. A total of 1,909 patients were eligible for the study, and 1,744 patients who underwent total gastrectomy (TG) or proximal gastrectomy (PG) were selected for the final analysis. These patients were divided into EGJC and UGC groups; thereafter, the PGSAS-45 main outcome measures (MOMs) were compared between the two groups for each type of gastrectomy.
Results
Among the post-TG patients, only one MOM was significantly better in the UGC group than in the EGJC group. Conversely, among the post-PG patients, postoperative QOL was significantly better in 6 out of 19 MOMs in the UGC group than in the EGJC group.
Conclusions
Tumor location had a minimal effect on the postoperative QOL of post-TG patients, whereas among post-PG patients, there were definite differences in postoperative QOL between the two groups. It seems reasonable to conservatively estimate the benefits of PG in patients with EGJC compared to those in patients with UGC.
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