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The evaluation of the postoperative quality of life in patients undergoing radical gastrectomy for esophagogastric junction cancer using the Postgastrectomy Syndrome Assessment Scale-45: a nationwide multi-institutional study

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Abstract

Purpose

This retrospective nationwide survey investigated the quality of life (QOL) of patients with esophagogastric junction cancer after gastrectomy using the Postgastrectomy Syndrome Assessment Scale-45.

Methods

The Postgastrectomy Syndrome Assessment Scale-45 comprises 45 questions classified into symptoms, living status, and QOL domains. A total of 1950 gastrectomized patients with upper-third gastric or esophagogastric junction cancer returned the completed forms. Among them, 224 eligible patients with esophagogastric junction cancer were selected, including 86, 120, and 18 patients who underwent total gastrectomy, proximal gastrectomy (reconstruction-esophagogastrostomy: 56; double-tract method: 51), and other procedures, respectively.

Results

The postoperative period was significantly shorter (47 ± 30 vs. 34 ± 30 months, p = 0.002), and the rates of early-stage disease and minimally invasive approaches significantly higher (both p < 0.001) in the proximal gastrectomy group than in the total gastrectomy group. Despite advantageous background factors for proximal gastrectomy, the postoperative QOL did not differ markedly between the groups. Compared to patients who underwent reconstruction with the double-tract method, patients who underwent esophagogastrostomy had significantly larger remnant stomachs but a similar QOL.

Conclusion

Even with total gastrectomy, a postoperative QOL comparable to that with proximal gastrectomy can be maintained. Clarifying the optimal reconstruction methods for proximal gastrectomy for esophagogastric junction cancer is warranted.

Trial registration

This study was registered at the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR; registration number: 000032221).

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Acknowledgements

The authors thank all physicians who participated in this study and the patients whose cooperation made this study possible.

Funding

This study was supported by grants from the Jikei University and the Japanese Gastric Cancer Association. The funding sources had no role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication.

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Authors and Affiliations

  1. Department of General and Gastroenterological Surgery, Osaka Medical and Pharmaceutical University, Takatsuki, Japan

    Sang-Woong Lee

  2. Department of Surgery, Toyama Prefectural Central Hospital, Toyama, Japan

    Masahide Kaji

  3. Department of Digestive Surgery, Imamura General Hospital, Kagoshima, Japan

    Yoshikazu Uenosono

  4. Department of Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan

    Mikihiro Kano

  5. Department of Surgery, Maebashi Red Cross Hospital, Maebashi, Japan

    Hisashi Shimizu

  6. Department of Gastroenterological Surgery, Oita Kouseiren Tsurumi Hospital, Beppu, Japan

    Takuya Noguchi

  7. Department of Gastroenterological Surgery and Oncology, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka, Japan

    Shugo Ueda

  8. Department of Surgery, Surgical Oncology and Science, Sapporo Medical University, Sapporo, Japan

    Takayuki Nobuoka

  9. Faculty of Letters, Arts and Sciences, Waseda University, Tokyo, Japan

    Atsushi Oshio

  10. Department of Laboratory Medicine, Jikei University School of Medicine, Tokyo, Japan

    Koji Nakada

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  1. Sang-Woong Lee
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Lee, SW., Kaji, M., Uenosono, Y. et al. The evaluation of the postoperative quality of life in patients undergoing radical gastrectomy for esophagogastric junction cancer using the Postgastrectomy Syndrome Assessment Scale-45: a nationwide multi-institutional study. Surg Today 52, 832–843 (2022). https://doi.org/10.1007/s00595-021-02400-8

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