Measuring the Quality of Life of Patients Undergoing Total or Subtotal Gastrectomy Due to Gastric Cancer

Abstract

Objective: Gastric cancer is prevalent both globally and in T & uuml;rkiye. The primary treatment for this condition is surgical resection. However, because the stomach plays a vital role in the digestive system, its removal can lead to significant morbidity and mortality, as well as considerable alterations in post-operative quality of life. To address these changes, questionnaires such as the EORTC QLQ-C30 and EORTC STO22 have been developed to assess physical, social, and psychological well-being. Methods: The quality of life of patients who underwent surgery for gastric cancer at Bezmialem University Faculty of Medicine was assessed using the EORTC QLQ-C30 and EORTC STO22 questionnaires, which are commonly utilized for measuring quality of life in Europe. Following the approval of the non-interventional ethics committee on July 10, 2018 (approval no: 15/183), a retrospective review was conducted of patients diagnosed with gastric cancer who had undergone either total or subtotal gastrectomy between October 2010 and April 2018. Demographic, pathological, and surgical data were collected. Eighty-five surviving patients, who were at least three months post-adjuvant therapy and free of recurrence, were contacted to participate. The Turkish versions of the EORTC QLQ-C30 and EORTC STO22 questionnaires were administered prospectively. Subsequently, statistical methods were employed to compare the total gastrectomy and subtotal gastrectomy groups. Results: A comparison was conducted between the pathologies and quality of life of 43 patients who underwent total gastrectomy and 42 patients who had subtotal gastrectomy. The results from the EORTC QLQ-C30 questionnaire indicated that diarrhea occurred more frequently in the total gastrectomy group. Additionally, the EORTC STO22 questionnaire revealed a higher incidence of dysphagia in this same group. Conclusion: Based on this information, it was concluded that patients who underwent subtotal and total gastrectomy experienced a similar global quality of life; however, specific symptoms such as diarrhea and dysphagia were more favorable in the subtotal group. It is recommended that distal subtotal gastrectomy be considered preferable, as long as surgical procedures adhere to oncological standards, since it better preserves patient comfort by limiting these specific postoperative symptoms.