Comparison of quality of life and worry of cancer recurrence between endoscopic and surgical treatment for early gastric cancer.

Abstract:

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.).

journal_name

Gastrointest Endosc

authors

Choi JH,Kim ES,Lee YJ,Cho KB,Park KS,Jang BK,Chung WJ,Hwang JS,Ryu SW

doi

10.1016/j.gie.2015.01.019

subject

Has Abstract

pub_date

2015-08-01 00:00:00

pages

299-307

issue

2

eissn

0016-5107

issn

1097-6779

pii

S0016-5107(15)00021-8

journal_volume

82

pub_type

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