BACKGROUND: The quality of life (QOL) of patients who survive early gastric cancer (EGC) is an area of increasing interest. OBJECTIVE: To compare the QOL and degree of worry of cancer recurrence in EGC patients who underwent endoscopic submucosal dissection (ESD) or surgery. DESIGN: Cross-sectional study. SETTINGS: A tertiary referral center. PATIENTS: A total of 565 patients with EGC who received ESD or surgery. INTERVENTION: Questionnaires. MAIN OUTCOME MEASUREMENTS: QOL was evaluated using the Short-form Health Survey and the European Organization for Research and Treatment of Cancer QOL questionnaires (QLQ-C30 and EORTC-QLQ-STO22). Mood disorders and the worry of cancer recurrence were estimated using the Hospital Anxiety and Depression Scale (HADS) and Worry of Cancer Scale, respectively. RESULTS: Questionnaires were completed by 55.7% of the ESD (137/246) and 58.9% of the surgery (188/319) patients. The surgery group had more QOL-related symptomatic and functional problems, including fatigue (P=.044), nausea/vomiting (P=.032), appetite loss (P=.023), diarrhea (P<.001), pain (P=.013), reflux symptoms (P=.005), eating restrictions (P<.001), anxiety (P=.015), taste impairment (P=.011), and poor body image (P<.001). The ESD group had significantly higher worry of cancer recurrence scores after adjusting for covariates, especially when visiting their physicians. The HADS results did not differ between the groups. LIMITATIONS: Cross-sectional design. CONCLUSIONS: Endoscopic treatment for EGC provides a better QOL, but stomach preservation might provoke cancer recurrence worries. Endoscopists should address this issue for relieving a patient's concern of cancer recurrence during follow-up period after ESD. ( CLINICAL TRIAL REGISTRATION NUMBER: WHO ICTRP KCT0000791.).
BACKGROUND: The quality of life (QOL) of patients who survive early gastric cancer (EGC) is an area of increasing interest. OBJECTIVE: To compare the QOL and degree of worry of cancer recurrence in EGCpatients who underwent endoscopic submucosal dissection (ESD) or surgery. DESIGN: Cross-sectional study. SETTINGS: A tertiary referral center. PATIENTS: A total of 565 patients with EGC who received ESD or surgery. INTERVENTION: Questionnaires. MAIN OUTCOME MEASUREMENTS: QOL was evaluated using the Short-form Health Survey and the European Organization for Research and Treatment of Cancer QOL questionnaires (QLQ-C30 and EORTC-QLQ-STO22). Mood disorders and the worry of cancer recurrence were estimated using the Hospital Anxiety and Depression Scale (HADS) and Worry of Cancer Scale, respectively. RESULTS: Questionnaires were completed by 55.7% of the ESD (137/246) and 58.9% of the surgery (188/319) patients. The surgery group had more QOL-related symptomatic and functional problems, including fatigue (P=.044), nausea/vomiting (P=.032), appetite loss (P=.023), diarrhea (P<.001), pain (P=.013), reflux symptoms (P=.005), eating restrictions (P<.001), anxiety (P=.015), taste impairment (P=.011), and poor body image (P<.001). The ESD group had significantly higher worry of cancer recurrence scores after adjusting for covariates, especially when visiting their physicians. The HADS results did not differ between the groups. LIMITATIONS: Cross-sectional design. CONCLUSIONS: Endoscopic treatment for EGC provides a better QOL, but stomach preservation might provoke cancer recurrence worries. Endoscopists should address this issue for relieving a patient's concern of cancer recurrence during follow-up period after ESD. ( CLINICAL TRIAL REGISTRATION NUMBER: WHO ICTRP KCT0000791.).
Authors: Young-Il Kim; Young Ae Kim; Chan Gyoo Kim; Keun Won Ryu; Young-Woo Kim; Jin Ah Sim; Young Ho Yun; Il Ju Choi Journal: Surg Endosc Date: 2017-10-24 Impact factor: 4.584