Serial intermediate-term quality of life comparison after endoscopic submucosal dissection versus surgery in early gastric cancer patients.

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Tytuł:: Serial intermediate-term quality of life comparison after endoscopic submucosal dissection versus surgery in early gastric cancer patients.
Autorzy:: Kim YI; Center for Gastric Cancer, National Cancer Center, Goyang, Republic of Korea.
Kim YA; Cancer Policy Branch, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea.
Kim CG; Center for Gastric Cancer, National Cancer Center, Goyang, Republic of Korea.
Ryu KW; Center for Gastric Cancer, National Cancer Center, Goyang, Republic of Korea.
Kim YW; Center for Gastric Cancer, National Cancer Center, Goyang, Republic of Korea.
Sim JA; Cancer Research Institute and Department of Biomedical Science, Seoul National University Hospital and College of Medicine, Seoul, Republic of Korea.
Yun YH; Cancer Research Institute and Department of Biomedical Science, Seoul National University Hospital and College of Medicine, Seoul, Republic of Korea. .
Choi IJ; Center for Gastric Cancer, National Cancer Center, Goyang, Republic of Korea. .
Źródło:: Surgical endoscopy [Surg Endosc] 2018 Apr; Vol. 32 (4), pp. 2114-2122. Date of Electronic Publication: 2017 Oct 24.
Typ publikacji:: Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
Język:: English
Imprint Name(s):: Publication: 1992- : New York : Springer
Original Publication: [Berlin] : Springer International, c1987-
MeSH Terms:: Endoscopic Mucosal Resection*
Gastrectomy*
Quality of Life*
Adenocarcinoma/*surgery
Stomach Neoplasms/*surgery
Adenocarcinoma/diagnosis ; Adenocarcinoma/mortality ; Adenocarcinoma/pathology ; Adult ; Aged ; Aged, 80 and over ; Early Detection of Cancer ; Female ; Follow-Up Studies ; Health Status Indicators ; Humans ; Male ; Middle Aged ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Prospective Studies ; Stomach Neoplasms/diagnosis ; Stomach Neoplasms/mortality ; Stomach Neoplasms/pathology ; Survival Analysis ; Treatment Outcome
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Contributed Indexing:: Keywords: Early gastric cancer; Endoscopic submucosal dissection; Quality of life; Surgery
Entry Date(s):: Date Created: 20171026 Date Completed: 20191003 Latest Revision: 20191007
Update Code:: 20240104
DOI:: 10.1007/s00464-017-5909-y
PMID:: 29067581
: Czasopismo naukowe

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Background: Endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) is expected to provide better long-term health-related quality of life (HRQOL) by preserving the entire stomach. We aimed to compare serial changes in HRQOL characteristics between patients who underwent ESD versus surgery for EGC.
Methods: A gastric cancer patient cohort was prospectively enrolled from 2004 to 2007. HRQOL of 161 EGC patients was prospectively assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC-QLQ-C30) and the stomach cancer-specific module EORTC-QLQ-STO22 at baseline (i.e., diagnosis) and at 1, 6, 12, 18, and 24 months of post-treatment.
Results: Of 161 patients, 48 (29.8%) underwent ESD and 113 (70.2%) underwent surgery. HRQOL parameters of ESD patients were similar to or better than baseline values. At 1-month post-treatment, the surgery group had significantly poorer scores than the ESD group (P < 0.05) for factors except emotional and cognitive functioning, financial problems, anxiety, and hair loss. However, most of the HRQOL parameters in the surgery group improved during the first post-treatment year, with between-group differences becoming insignificant. Only five parameters (physical functioning, eating restriction, dysphagia, diarrhea, and body image) remained significantly better in the ESD group than the surgery group for > 1-year post-treatment (P < 0.05). The surgery group had significantly higher treatment-associated complications than the ESD group (15.0 vs. 2.1%; P = 0.017). The overall survival was not different between the both groups (5-year overall survival rates, 97.7% in the ESD group vs. 99.1% in the surgery group; P = 0.106 by the log-rank test).
Conclusion: Compared with surgery, ESD can provide better HRQOL benefits for EGC patients, especially during the early post-treatment period. However, surgical treatment should not be rejected only due to the concern about HRQOL impairments because most of them improved during follow-up periods.

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