Health-Related Quality of Life Post Gastrectomy: A Quantitative and Qualitative Cross-Sectional Analysis

Approximately eight per 1000 patients develop gastric cancer in the US. Surgery serves as part of curative intent treatment, but subsequent changes to diet, digestion, and financial burden may impact lifestyle for many. Health-related quality of life (HRQoL) changes following gastric cancer surgery have not been fully explored.

A cross-sectional study design explored patients' HRQoL measures after undergoing total and subtotal gastrectomy. Participants were surveyed using European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaires (QLQ)-C30, gastric cancer-specific QLQ-STO22, and open-ended questions regarding impact of cancer on family life, social activity, finances, and life reflection. QLQ-C30 data were also compared to age-adjusted normative controls. Global health status, function, and symptom scales were assessed.

Out of 92 eligible patients, 57 chose to participate (62%). A total of 45 patients had subtotal gastrectomy (79%) and 12 underwent total gastrectomy (21%), with median overall follow-up time of 71 mo. QLQ-30 measures of nausea, vomiting, and diarrhea occurred with greater frequency among patients' postgastrectomy (all P ≤ 0.041). Numerous QLQ-STO22 HRQoL measures were statistically marginal after total gastrectomy rather than subtotal (P ≤ 0.080). Themes of adjustment, outlook, and minimal disruption emerged from the data. One subject noted: "I just do everything normal. I don't even realize that… I don't have a stomach. It doesn't have any effect on anything I do."

Assessing HRQoL provides information about patients' health and experiences with their disease, which may influence clinical decision-making. Understanding patient experience is important to providing better and more individualized patient care.