title: Quality of life after gastrectomy for cancer evaluated via the EORTC QLQ-C30 and QLQ-STO22 questionnaires: surgical considerations from the analysis of 103 patients.
abstract: OBJECTIVE
  Gastric surgery is a major operation which can cause a related potential deterioration in the patient's quality of life (QoL). This retrospective study investigates the factors which can influence QoL in patients who underwent curative total or subtotal gastrectomy for cancer.
  
  
  METHODS
  One hundred and three patients were treated via gastrectomy between August 1990 and September 2012: 48 total gastrectomies with Roux-en-Y reconstruction and 55 subtotal resections (among the latter there were 15 Roux-en-Y and 40 Billroth II reconstructions). All patients were interviewed to evaluate their QoL using the EORTC QLQ-C30 and QLQ-STO22 questionnaires. Non-parametric tests were used to analyze the data collected during the interviews considering patient-, tumor- and treatment-related factors. The analysis was corrected for potential confounding factors, in particular considering new onset variables (e.g. comorbidity, treatment and age at time of the interview).
  
  
  RESULTS
  QoL correlated negatively with tumor stage and total gastrectomy. In particular, a larger resection for an advanced cancer seems to cause a worse QoL. Furthermore, total gastrectomy is associated with several upper-gastrointestinal tract symptoms. Moreover, after distal resection, patients with a Billroth II reconstruction complain more frequently of dumping syndrome-related symptoms than patients with a Roux-en-Y reconstruction.
  
  
  CONCLUSIONS
  QoL after gastric surgery for cancer is affected by tumor- and treatment-related factors. In order to improve patients' QoL, subtotal resection with Roux-en-Y reconstruction should be preferred whenever oncologically acceptable.
authors.affiliation: Department of Surgical Sciences Insubria University Varese-Como, 1st Division of Surgery Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Rausei
authors.affiliation: Department of Surgical Sciences Insubria University Varese-Como, 1st Division of Surgery Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Mangano
authors.affiliation: Department of Surgical Sciences Insubria University Varese-Como, 1st Division of Surgery Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Galli
authors.affiliation: Department of Surgical Sciences Insubria University Varese-Como, 1st Division of Surgery Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Rovera
authors.affiliation: Department of Surgical Sciences Insubria University Varese-Como, 1st Division of Surgery Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Boni
authors.affiliation: Department of Surgical Sciences Insubria University Varese-Como, 1st Division of Surgery Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
authors.forename: Gianlorenzo
authors.initials: G
authors.lastname: Dionigi
authors.affiliation: Department of Surgical Sciences Insubria University Varese-Como, 1st Division of Surgery Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
authors.forename: Renzo
authors.initials: R
authors.lastname: Dionigi
mesh_terms: D000368:Aged; D000713:Anastomosis, Roux-en-Y; D005260:Female; D005743:Gastrectomy / Q000379:methods* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000523:psychology / Q000601:surgery*; D011795:Surveys and Questionnaires
keywords: Bilroth II reconstruction; Gastrectomy; Gastric cancer; Quality of life; Roux-en-Y reconstruction