Chie Tanaka1, Mitsuro Kanda1, Kenta Murotani2, Takaki Yoshikawa3, Haruhiko Cho4, Yuichi Ito5, Takanori Matsui6, Hiroshi Nakayama7, Takanobu Yamada8, Daisuke Kobayashi1, Michitaka Fujiwara1, Yasuhiro Kodera9. 1. Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan. 2. Biostatistics Center, Graduate School of Medicine, Kurume University, Fukuoka, Japan. 3. Department of Gastric Surgery, National Cancer Center Hospital, Tokyo, Japan. 4. Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan. 5. Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Japan. 6. Department of Gastroenterological Surgery, Aichi Cancer Center Aichi Hospital, Okazaki, Japan. 7. Department of Surgery, Meitetsu Hospital, Nagoya, Japan. 8. Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan. 9. Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan. ykodera@med.nagoya-u.ac.jp.
Abstract
BACKGROUND: Several efforts have been made to alleviate harms and symptoms after gastrectomy for gastric cancer. We previously conducted a randomized controlled trial (CCOG1101) to compare quality of life (QOL) and nutritional status between Roux-en-Y (RY) and aboral pouch (AP) reconstructions for up to 1 year after total gastrectomy. However, long-term outcomes after AP reconstruction remain unclear. METHODS: A prospective multicenter observational study was conducted to compare QOL, body composition, and nutritional indicators between the RY and AP reconstructionsat 5 years after surgery among patients who were enrolled in the CCOG1101 trial. QOL was assessed by the PGSAS-37 questionnaires as well as the EORTC QLQ-C30 and STO22. RESULTS:Sixty patients (31 for RY and 29 for AP) were recruited for analysis. There were no significant differences in baseline and perioperative characteristics between the two groups. No significant differences were found in the EORTC QLQ-C30 global health status and functional scales. Regarding symptom scales in the QLQ-C30 and STO22, a more favorable score for the diarrhea scale was observed in the AP group. Diarrhea was also the only item in the PGSAS-37 questionnaires in which significant benefit of AP was observed. Body weight and lean body mass continued to decrease throughout the postoperative 5 years in both groups. None of the conventional nutritional indicators using the serum samples showed significant difference between the two groups. CONCLUSIONS: Long-term observation suggested little benefit of AP reconstruction after total gastrectomy other than in alleviating diarrhea.
RCT Entities:
BACKGROUND: Several efforts have been made to alleviate harms and symptoms after gastrectomy for gastric cancer. We previously conducted a randomized controlled trial (CCOG1101) to compare quality of life (QOL) and nutritional status between Roux-en-Y (RY) and aboral pouch (AP) reconstructions for up to 1 year after total gastrectomy. However, long-term outcomes after AP reconstruction remain unclear. METHODS: A prospective multicenter observational study was conducted to compare QOL, body composition, and nutritional indicators between the RY and AP reconstructions at 5 years after surgery among patients who were enrolled in the CCOG1101 trial. QOL was assessed by the PGSAS-37 questionnaires as well as the EORTC QLQ-C30 and STO22. RESULTS: Sixty patients (31 for RY and 29 for AP) were recruited for analysis. There were no significant differences in baseline and perioperative characteristics between the two groups. No significant differences were found in the EORTC QLQ-C30 global health status and functional scales. Regarding symptom scales in the QLQ-C30 and STO22, a more favorable score for the diarrhea scale was observed in the AP group. Diarrhea was also the only item in the PGSAS-37 questionnaires in which significant benefit of AP was observed. Body weight and lean body mass continued to decrease throughout the postoperative 5 years in both groups. None of the conventional nutritional indicators using the serum samples showed significant difference between the two groups. CONCLUSIONS: Long-term observation suggested little benefit of AP reconstruction after total gastrectomy other than in alleviating diarrhea.
Entities:
Keywords:
Aboral pouch; Body composition; Gastric cancer; Quality of life; Total gastrectomy