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

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

Gastrointest Endosc. 2015 Aug;82(2):299-307

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

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.).

PMID: 25892060 [PubMed - indexed for MEDLINE]

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