title: Comparison of quality of life and worry of cancer recurrence between endoscopic and surgical treatment for early gastric cancer.
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.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  A tertiary referral center.
  
  
  METHODS
  A total of 565 patients with EGC who received ESD or surgery.
  
  
  METHODS
  Questionnaires.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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. (
  
  
  BACKGROUND
  WHO ICTRP KCT0000791.).
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, South Korea.
authors.forename: Jae Hyuk
authors.initials: JH
authors.lastname: Choi
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, South Korea.
authors.forename: Eun Soo
authors.initials: ES
authors.lastname: Kim
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, South Korea.
authors.forename: Yoo Jin
authors.initials: YJ
authors.lastname: Lee
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, South Korea.
authors.forename: Kwang Bum
authors.initials: KB
authors.lastname: Cho
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, South Korea.
authors.forename: Kyung Sik
authors.initials: KS
authors.lastname: Park
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, South Korea.
authors.forename: Byoung Kuk
authors.initials: BK
authors.lastname: Jang
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, South Korea.
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Chung
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, South Korea.
authors.forename: Jae Seok
authors.initials: JS
authors.lastname: Hwang
authors.affiliation: Department of Surgery, Keimyung University School of Medicine, Daegu, South Korea.
authors.forename: Seung Wan
authors.initials: SW
authors.lastname: Ryu
mesh_terms: D000368:Aged; D001007:Anxiety / Q000209:etiology*; D001066:Appetite; D001828:Body Image; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology; D003967:Diarrhea / Q000209:etiology; D004210:Dissection / Q000523:psychology; D005221:Fatigue / Q000209:etiology; D005260:Female; D005753:Gastric Mucosa / Q000601:surgery; D005764:Gastroesophageal Reflux / Q000209:etiology; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000209:etiology; D009364:Neoplasm Recurrence, Local / Q000523:psychology*; D010146:Pain / Q000209:etiology; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology*; D013274:Stomach Neoplasms / Q000150:complications / Q000523:psychology* / Q000601:surgery*; D011795:Surveys and Questionnaires; D013651:Taste Disorders / Q000209:etiology; D014839:Vomiting / Q000209:etiology