Quality of Life after Endoscopic Submucosal Dissection for Early Gastric Cancer: A Prospective Multicenter Cohort Study.
OBJECTIVE
Endoscopic submucosal dissection (ESD) has been an established treatment for indicated early gastric cancer (EGC) without deterioration of quality of life (QOL) compared with surgical resection. The aim of this study was to evaluate long-term QOL in patients undergoing ESD for EGC.


METHODS
Patients scheduled to undergo curative ESD for EGC were prospectively enrolled from 12 institutions between May 2010 and December 2011. Assessments of QOL with Korean versions of the European Organization for Research and Treatment of Cancer (EORTC) QOL questionnaire-core (QLQ-C30) and a gastric cancer-specific questionnaire (STO22) were performed at baseline and at 7 days, 3 months, and 6 months after ESD.


RESULTS
A total of 666 subjects were assessed for QLQ-C30 and QLQ-STO22. The mean QLQ-C30 score was 69.5 at baseline, 68.8 at 7 days, 73.1 at 3 months, and 73.2 at 6 months. The global health status on the EORTC QLQ-C30 was significantly improved after 3 and 6 months (p=0.0003 and p<0.0001, respectively). The QLQ-C30 and STO22 scores were not significantly different, or they only slightly deteriorated between before and immediately after ESD, but they were significantly improved after 3 and 6 months (p<0.05).


CONCLUSIONS
QOL did not deteriorate immediately after ESD, and it improved more significantly at up to 6 months in patients who underwent curative ESD for EGC without significant complications.
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Sang Gyun
SG
Kim
National Evidence-Based Healthcare Collaborating Agency, Seoul, Korea.|National Health Insurance Service, Seoul, Korea.
Seon Mi
SM
Ji
National Evidence-Based Healthcare Collaborating Agency, Seoul, Korea.
Na Rae
NR
Lee
National Evidence-Based Healthcare Collaborating Agency, Seoul, Korea.
Seung-Hee
SH
Park
National Evidence-Based Healthcare Collaborating Agency, Seoul, Korea.
Ji Hye
JH
You
Center for Gastric Cancer, National Cancer Center, Goyang, Korea.
Il Ju
IJ
Choi
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Wan Sik
WS
Lee
Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
Seun Ja
SJ
Park
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Jun Haeng
JH
Lee
Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea.
Sang-Yong
SY
Seol
Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea.
Ji Hyun
JH
Kim
Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
Chul-Hyun
CH
Lim
Digestive Disease Center, Soonchunhyang University Hospital, Seoul, Korea.|Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
Joo Young
JY
Cho
Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
Gwang Ha
GH
Kim
Department of Internal Medicine, Institute of Digestive Diseases and Nutrition, Korea University College of Medicine, Seoul, Korea.
Hoon Jai
HJ
Chun
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Yong Chan
YC
Lee
Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Hwoon-Yong
HY
Jung
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Jae J
JJ
Kim
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000368:Aged; D015331:Cohort Studies; D000069916:Endoscopic Mucosal Resection; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D011788:Quality of Life; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D011795:Surveys and Questionnaires
Early gastric cancer; Endoscopic submucosal dissection; Quality of life