Skip to main content


Log in

Assessment of Quality of Life After Gastrectomy Using EORTC QLQ-C30 and STO22

  • Published:
World Journal of Surgery Aims and scope Submit manuscript



The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire–Cancer (QLQ-C30) and the site-specific module for gastric cancer (QLQ-STO22) have seldom been used to measure the postoperative health-related quality of life (HRQOL) in Japanese gastric cancer patients. The aim of this study was to evaluate the HRQOL after gastrectomy using these instruments and to compare various aspects of HRQOL among surgical procedures.


A total of 98 patients who underwent gastrectomy and had no recurrence were evaluated. Among them, we compared the differences between major surgical procedures consisting of open total gastrectomy (TG, n = 8), open distal gastrectomy (DG, n = 24), and laparoscopy-assisted distal gastrectomy (LADG, n = 44). Questionnaires were completed at baseline and at 1, 3, 6 and 12 months postoperatively.


The worst scores for most of the items were observed at 1 month after surgery and usually improved thereafter. Scores after TG were the worst of all surgical procedures across all dimensions throughout the period. Scores after LADG were generally superior to those after DG at 1 and 3 months postoperatively but not at 12 months.


EORTC QLQ-C30 and STO22 detected differences in several aspects of HRQOL among patients treated by the three surgical procedures. The laparoscopic approach resulted in superior short-term outcomes, whereas TG continued to affect the HRQOL in several items 12 months after surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others


  1. Yokota T, Ishiyama S, Saito T et al (2003) Treatment strategy of limited surgery in the treatment guidelines for gastric cancer in Japan. Lancet Oncol 4:423–428

    Article  PubMed  Google Scholar 

  2. Akoh JA, Machintyre IM (1970) Improving survival in gastric cancer: review of 5-year survival rates in English language publications from 1970. Br J Surg 79:293–299

    Article  Google Scholar 

  3. Maruyama K, Okabayashi K, Kinoshita T (1987) Progress in gastric cancer surgery in Japan and its limits of radicality. World J Surg 11:418–425

    Article  CAS  PubMed  Google Scholar 

  4. Korenaga D, Tsujitani S, Haraguchi M et al (1998) Long-term survival in Japanese patients with far advanced carcinoma of the stomach. World J Surg 12:236–240

    Article  Google Scholar 

  5. Köckerling F, Reck T, Gall FP (1995) Extended gastrectomy: who benefits? World J Surg 19:541–545

    Article  PubMed  Google Scholar 

  6. Sanders C, Egger M, Donovan J et al (1998) Reporting on quality of life in randomized controlled trials: bibliographic study. BMJ 317:1191–1194

    CAS  PubMed  Google Scholar 

  7. Thybush-Bernhardt A, Schmidt C, Küchler T et al (1999) Quality of life following radical surgical treatment of gastric carcinoma. World J Surg 23:503–508

    Article  Google Scholar 

  8. Huang C, Lien H, Wang P et al (2007) Quality of life in disease-free gastric adenocarcinoma survivors: impacts of clinical stages and reconstructive surgical procedures. Dig Surg 24:59–65

    Article  CAS  PubMed  Google Scholar 

  9. Wu C, Chiou J, Ko F et al (2008) Quality of life after curative gastrectomy for gastric cancer in a randomized controlled trial. Br J Cancer 98:54–59

    Article  PubMed  Google Scholar 

  10. Avery K, Hughes R, McNair A et al (2010) Health-related quality of life and survival in the 2 years after surgery for gastric cancer. Eur J Surg Oncol 36:148–154

    CAS  PubMed  Google Scholar 

  11. Aaronson NK, Ahmedzai S, Bergman B et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality of life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376

    Article  CAS  PubMed  Google Scholar 

  12. Vickery CW, Blazeby JM, Conroy T et al (2001) Development of an EORTC disease specific quality of life module for use in patients with gastric cancer. Eur J Cancer 37:966–971

    Article  CAS  PubMed  Google Scholar 

  13. Blazeby JM, Conroy T, Bottomley A et al (2004) Clinical and psychometoric validation of a questionnaire module, the EORTC QLQ-STO22, to assess quality of life in patients with gastric cancer. Eur J Cancer 40:2260–2268

    Article  CAS  PubMed  Google Scholar 

  14. Kobayashi K, Takeda F, Teramukai S et al (1998) A cross-validation of the European Organization for Research and Treatment of Cancer QLQ-C30 (EORTC QLQ-C30) for Japanese with lung cancer. Eur J Cancer 34:810–815

    Article  CAS  PubMed  Google Scholar 

  15. Morita S, Kaptein AA, Oba K et al (2008) The domain structure of the EORTC QLQ-STO22 supported by Japanese validation data. Psychooncology 17:474–479

    Article  PubMed  Google Scholar 

  16. Fayers PM, Aaronson NK, Bjordal K et al (2001) EORTC QLQ-C30 scoring manual, 3rd edn. EORTC, Brussels

    Google Scholar 

  17. Fayers P, Bottomley A (2002) Quality of life research within the EORTC: the EORTC QLQ-C30—European Organization for Research and Treatment of Cancer. Eur J Cancer 38:S125–S133

    Article  PubMed  Google Scholar 

  18. Davies J, Johnston D, Sue-Ling H et al (1998) Total or subtotal gastrectomy for gastric carcinoma? A study of quality of life. World J Surg 22:1048–1055

    Article  CAS  PubMed  Google Scholar 

  19. Korenaga D, Orita H, Okuyama T et al (1992) Quality of life after gastrectomy in patients with carcinoma of the stomach. Br J Surg 79:248–250

    Article  CAS  PubMed  Google Scholar 

  20. Anderson I, Machintyre I (1995) Symptomatic outcome following resection of gastric cancer. Surg Oncol 4:35–40

    Article  CAS  PubMed  Google Scholar 

  21. Bozzetti F, Ravera E, Cozzaglio L et al (1990) Comparison of nutritional status after total or subtotal gastrectomy. Nutrition 6:371–375

    CAS  PubMed  Google Scholar 

  22. Kitano S, Iso Y, Moriyama M (1994) Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc 4:146–148

    CAS  PubMed  Google Scholar 

  23. Huscher CG, Mingoli A, Sgarzini G et al (2005) Laparosopic versus open subtotal gastrectomy for distal gastric cancer: five-year results of a randomized prospective trial. Ann Surg 241:232–237

    Article  PubMed  Google Scholar 

  24. Yasuda K, Shiraishi T, Etoh A et al (2007) Long-term quality of life after laparoscopy-assisted distal gastrectomy for gastric cancer. Surg Endosc 21:2150–2153

    Article  CAS  PubMed  Google Scholar 

  25. Kitano S, Shiraishi N, Fujii K et al (2002) A randomized controlled trial comparing open vs laparoscopy-assisted distal gasrectomy for the treatment of early gastric cancer: an interim report. Surgery 131:306–311

    Article  Google Scholar 

  26. Kim YW, Baik YH, Yun YH et al (2008) Improved quality of life outcomes after laparoscopy-assisted distal gastrectomy for early gastric cancer: results of a prospective randomized clinical trial. Ann Surg 248:721–727

    Article  PubMed  Google Scholar 

Download references

Conflict of interest


Author information

Authors and Affiliations


Corresponding author

Correspondence to Daisuke Kobayashi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kobayashi, D., Kodera, Y., Fujiwara, M. et al. Assessment of Quality of Life After Gastrectomy Using EORTC QLQ-C30 and STO22. World J Surg 35, 357–364 (2011).

Download citation

  • Published:

  • Issue Date:

  • DOI: