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Observational Study
. 2025 Apr;25(2):382-399.
doi: 10.5230/jgc.2025.25.e26.

Prospective Multicenter Observational Study on Postoperative Quality of Life According to Type of Gastrectomy for Gastric Cancer

Sung Eun Oh #  1 , Yun-Suhk Suh #  2 , Ji Yeong An  1 , Keun Won Ryu  3 , In Cho  4 , Sung Geun Kim  5 , Ji-Ho Park  6 , Hoon Hur  7 , Hyung-Ho Kim  2 , Sang-Hoon Ahn  2 , Sun-Hwi Hwang  8 , Hong Man Yoon  3 , Ki Bum Park  9 , Hyoung-Il Kim  10 , In Gyu Kwon  11 , Han-Kwang Yang  12 , Byoung-Jo Suh  13 , Sang-Ho Jeong  14 , Tae-Han Kim  14 , Oh Kyoung Kwon  9 , Hye Seong Ahn  15 , Ji Yeon Park  9 , Ki Young Yoon  16 , Myoung Won Son  17 , Seong-Ho Kong  12 , Young-Gil Son  18 , Geum Jong Song  17 , Jong Hyuk Yun  17 , Jung-Min Bae  19 , Do Joong Park  12 , Sol Lee  20 , Jun-Young Yang  21 , Kyung Won Seo  16 , You-Jin Jang  22 , So Hyun Kang  2 , Bang Wool Eom  3 , Joongyub Lee #  23 , Hyuk-Joon Lee #  24 ; Korean Quality of Life in Stomach Cancer Patients Study (KOQUSS) Group
Affiliations
Observational Study

Prospective Multicenter Observational Study on Postoperative Quality of Life According to Type of Gastrectomy for Gastric Cancer

Sung Eun Oh et al. J Gastric Cancer. 2025 Apr.

Abstract

Purpose: This study evaluated the postoperative quality of life (QoL) after various types of gastrectomy for gastric cancer.

Materials and methods: A multicenter prospective observational study was conducted in Korea using the Korean Quality of Life in Stomach Cancer Patients Study (KOQUSS)-40, a new QoL assessment tool focusing on postgastrectomy syndrome. Overall, 496 patients with gastric cancer were enrolled, and QoL was assessed at 5 time points: preoperatively and at 1, 3, 6, and 12 months after surgery.

Results: Distal gastrectomy (DG) and pylorus-preserving gastrectomy (PPG) showed significantly better outcomes than total gastrectomy (TG) and proximal gastrectomy (PG) with regard to total score, indigestion, and dysphagia. DG, PPG, and TG also showed significantly better outcomes than PG in terms of dumping syndrome and worry about cancer. Postoperative QoL did not differ significantly according to anastomosis type in DG, except for Billroth I anastomosis, which achieved better bowel habit change scores than the others. No domains differed significantly when comparing double tract reconstruction and esophagogastrostomy after PG. The total QoL score correlated significantly with postoperative body weight loss (more than 10%) and extent of resection (P<0.05 for both). Reflux as assessed by KOQUSS-40 did not correlate significantly with reflux observed on gastroscopy 1 year postoperatively (P=0.064).

Conclusions: Our prospective observation using KOQUSS-40 revealed that DG and PPG lead to better QoL than TG and PG. Further study is needed to compare postoperative QoL according to anastomosis type in DG and PG.

Keywords: Gastrectomy; Quality of life; Stomach neoplasm; Survey and questionnaire.

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Conflict of interest statement

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

Figures

Fig. 1
Fig. 1. Flowchart and flow diagram. (A) Study flowchart and (B) flow diagram of patient selection.
QoL = quality of life; Bwt = body weight; UGIS = upper gastrointestinal series; EGD = esophagogastroduodenoscopy.
Fig. 2
Fig. 2. Postoperative KOQUSS-40 total scores according to the type of gastric resection. Plotted with the mean difference and standard error (error bars).
DG = distal gastrectomy; PG = proximal gastrectomy; PPG = pylorus-preserving gastrectomy; TG = total gastrectomy; KOQUSS = the Korean Quality of Life in Stomach Cancer Patients Study.
Fig. 3
Fig. 3. Scores for the 9 KOQUSS-40 domains according to the type of gastric resection. Plotted with the mean difference and standard error (error bars).
KOQUSS = the Korean Quality of Life in Stomach Cancer Patients Study. *Distal gastrectomy vs. proximal gastrectomy (P<0.05).
Fig. 4
Fig. 4. Postoperative KOQUSS-40 total scores according to the type of anastomosis after distal gastrectomy.
Plotted with the mean difference and standard error (error bars). B-I = Billroth I anastomosis; B-II = Billroth II anastomosis; RY = Roux-en-Y; KOQUSS = the Korean Quality of Life in Stomach Cancer Patients Study.
Fig. 5
Fig. 5. Postoperative KOQUSS-40 total scores according to the type of anastomosis after proximal gastrectomy. Plotted with the mean difference and standard error (error bars).
DTR = double-tract reconstruction; EG = esophagogastrostomy; KOQUSS = the Korean Quality of Life in Stomach Cancer Patients Study.
See this image and copyright information in PMC

References

    1. Choi KS, Jun JK, Suh M, Park B, Noh DK, Song SH, et al. Effect of endoscopy screening on stage at gastric cancer diagnosis: results of the National Cancer Screening Programme in Korea. Br J Cancer. 2015;112:608–612. - PMC - PubMed
    1. Information Committee of the Korean Gastric Cancer Association. Korean Gastric Cancer Association-led nationwide survey on surgically treated gastric cancers in 2019. J Gastric Cancer. 2021;21:221–235. - PMC - PubMed
    1. Hong S, Won YJ, Lee JJ, Jung KW, Kong HJ, Im JS, et al. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2018. Cancer Res Treat. 2021;53:301–315. - PMC - PubMed
    1. Bolton JS, Conway WC., 2nd Postgastrectomy syndromes. Surg Clin North Am. 2011;91:1105–1122. - PubMed
    1. Davis JL, Ripley RT. Postgastrectomy syndromes and nutritional considerations following gastric surgery. Surg Clin North Am. 2017;97:277–293. - PubMed

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