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. 2022 Jul;22(3):235-247.
doi: 10.5230/jgc.2022.22.e23.

Impact of Tumor Location on the Quality of Life of Patients Undergoing Total or Proximal Gastrectomy

Muneharu Fujisaki  1 , Takashi Nomura  2 , Hiroharu Yamashita  3 , Yoshikazu Uenosono  4 , Tetsu Fukunaga  5 , Eigo Otsuji  6 , Masahiro Takahashi  7 , Hideo Matsumoto  8 , Atsushi Oshio  9 , Koji Nakada  10
Affiliations

Impact of Tumor Location on the Quality of Life of Patients Undergoing Total or Proximal Gastrectomy

Muneharu Fujisaki et al. J Gastric Cancer. 2022 Jul.

Abstract

Purpose: Most studies have investigated the differences in postgastrectomy quality of life (QOL) based on the surgical procedure or reconstruction method adopted; only a few studies have compared QOL based on tumor location. This large-scale study aims to investigate the differences in QOL between patients with esophagogastric junction cancer (EGJC) and those with upper third gastric cancer (UGC) undergoing the same gastrectomy procedure to evaluate the impact of tumor location on postoperative QOL.

Methods: The Postgastrectomy Syndrome Assessment Scale-45 (PGSAS-45) questionnaire was distributed in 70 institutions to 2,364 patients who underwent gastrectomy for EGJC or UGC. A total of 1,909 patients were eligible for the study, and 1,744 patients who underwent total gastrectomy (TG) or proximal gastrectomy (PG) were selected for the final analysis. These patients were divided into EGJC and UGC groups; thereafter, the PGSAS-45 main outcome measures (MOMs) were compared between the two groups for each type of gastrectomy.

Results: Among the post-TG patients, only one MOM was significantly better in the UGC group than in the EGJC group. Conversely, among the post-PG patients, postoperative QOL was significantly better in 6 out of 19 MOMs in the UGC group than in the EGJC group.

Conclusions: Tumor location had a minimal effect on the postoperative QOL of post-TG patients, whereas among post-PG patients, there were definite differences in postoperative QOL between the two groups. It seems reasonable to conservatively estimate the benefits of PG in patients with EGJC compared to those in patients with UGC.

Keywords: Esophagogastric Junction; Gastrectomy; Gastric cancer; Quality of life.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. Study outline.
CTx = chemotherapy; TG = total gastrectomy; PG = proximal gastrectomy; TGJP = total gastrectomy with jejunal pouch reconstruction; TEGT = thoracic esophagectomy with gastric-tube reconstruction; SRDG = small remnant distal gastrectomy.
See this image and copyright information in PMC

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