title: Health-related quality of life among patients with adenocarcinoma of the gastro-oesophageal junction treated by gastrectomy or oesophagectomy.
abstract: BACKGROUND
  Tumours of the gastro-oesophageal junction may be resected by total gastrectomy (TG) or transthoracic oesophagectomy (TTO). This study compared health-related quality of life (HRQL) following these procedures.
  
  
  METHODS
  Prospective clinical and HRQL data (European Organization for Research and Treatment of Cancer QLQ-C30) were collected from 63 consecutive patients (20 TG and 43 TTO) before and 6 months after surgery for Siewert type I-III gastro-oesophageal tumours.
  
  
  RESULTS
  Questionnaire response rates exceeded 90 per cent. Patients were similar with respect to disease stage, treatment-related mortality and survival, but those selected for TTO were younger with less co-morbidity than those undergoing TG. These differences were reflected in baseline HRQL scores, which were better in patients selected for TTO. Six months after surgery, however, HRQL showed a greater deterioration after TTO than after TG in terms of role and social function, global quality of life and fatigue. Symptom scores for pain and diarrhoea increased in both groups.
  
  
  CONCLUSIONS
  TTO had a greater negative impact on HRQL than TG for tumours of the gastro-oesophageal junction.
authors.affiliation: Division of Surgery, Head and Neck, United Bristol Healthcare Trust, Bristol, UK.
authors.forename: A P
authors.initials: AP
authors.lastname: Barbour
authors.forename: P
authors.initials: P
authors.lastname: Lagergren
authors.forename: R
authors.initials: R
authors.lastname: Hughes
authors.forename: D
authors.initials: D
authors.lastname: Alderson
authors.forename: C P
authors.initials: CP
authors.lastname: Barham
authors.forename: J M
authors.initials: JM
authors.lastname: Blazeby
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D000368:Aged; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D004943:Esophagogastric Junction / Q000601:surgery*; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D007902:Length of Stay; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D013274:Stomach Neoplasms / Q000601:surgery*; D016896:Treatment Outcome