Quality of life: A critical outcome for all surgical treatments of gastric cancer

Table 1 Comparison of gastric cancer-specific quality of life questionnaires

	EORTC QLQ-STO22	FACT-Ga	DAUGS32
Year introduced	2001	2004	2005
Validated?	Yes	Yes	Yes
Parent questionnaire	EORTC QLQ-C30	FACT-G	None
Number of items/questions	22	19	32
Focus	Patient symptoms	Emotional and physical symptoms	Gastrointestinal dysfunction
Applicable to all treatment modalities?	Yes	Yes	No (surgery only)

Table 2 Quality of life tools utilized in the included references

Author	Year	Main QoL outcome	QoL tool
Korenaga et al[37]	1992	QoL - single time point	Interview, non-validated
Davies et al[40]	1998	Comparison of extent of surgery (DG vs TG)	RSCL, Troidl, HAD, ADLs
Spector et al[63]	2002	Comparison of approaches to GEJ tumors	GIQLI, LAGS
Díaz De Liaño et al[68]	2003	Comparison of extent of resection and nodal dissection	QLQ-C30
Barbour et al[62]	2008	Comparison of approaches to GEJ tumors	QLQ-C30
Kim et al[71]	2008	Comparison of lap vs open for DG	QLQ-C30, QLQ-STO22
Tyrväinen et al[38]	2008	Long-term QoL	SF-36, 15D
Avery et al[34]	2010	Longitudinal follow-up after TG and DG	QLQ-C30, QLQ-STO22
Lee et al[36]	2010	Long-term QoL	QLQ-C30, QLQ-STO22
Jeurnink et al[90]	2010	Surgical GJ vs stent for GOO	QLQ-C30, EuroQoL-5D, EuroQoL-VAS, QLQ-PAN26
Kobayashi et al[42]	2011	Comparison of extent (DG vs TG)and method (lap vs open) of surgery	QLQ-C30, QLQ-STO22
Kim et al[35]	2012	Longitudinal follow-up after TG and DG	QLQ-C30, QLQ-STO22
Kulig et al[85]	2012	QoL in non-curative resection	QLQ-C30
Lee et al[48]	2012	Comparison of reconstruction after DG (BI vs BII vs R-Y)	GIQLI
Munene et al[11]	2012	Longitudinal follow-up, comparison of extent of surgery (DG vs TG)	FACT-Ga
Takiguchi et al[49]	2012	Comparison of reconstruction after DG (BI vs R-Y)	QLQ-C30, DAUGS 20
Karanicolas et al[33]	2013	Comparison of extent of surgery (DG vs TG vs PG)	QLQ-C30, QLQ-STO22
Rausei et al[43]	2013	Comparison of extent of surgery (DG vs TG)	QLQ-C30, QLQ-STO22
Park et al[44]	2014	Comparison of extent of surgery (DG vs TG)	QLQ-C30, QLQ-STO22
Takiguchi et al[29]	2014	TG vs PG for proximal gastric tumors	PGSAS-45
Worster et al[99]	2014	Longitudinal study, prophylactic gastrectomy patients	QLQ-C30, QLQ-STO22
Ronellenfitsch et al[57]	2015	Longitudinal follow-up after PG	FACT-E

ADL: Activities of daily living; TG: Total gastrectomy; DG: Distal gastrectomy; FACT: Functional assessment of cancer therapy (-G: Gastric, -E: Esophageal); GEJ: Gastroesophageal junction; GJ: Gastrojejunostomy; GIQLI: Gastrointestinal Quality of Life Index; GOO: Gastric outlet obstruction; HAD: Hospital anxiety and depression scale; LAGS: Life after gastric surgery; PGSAS: Postgastrectomy syndrome assessment scale; RSCL: Rotterdam symptom checklist; QoL: Quality of life.

Table 3 Surgery and quality of life in gastric cancer

Type of surgical therapy	Quality of life summary
Resection for cure	DG leads to better QoL
	TG is superior to PG for proximal cancers
	For GEJ tumors, abdominal procedures are associated with better QoL
	Laparoscopy is likely associated with quicker attainment of post-operative QoL
	Goal is return to baseline QoL
Palliative resection	Non surgical (less invasive) procedures are desirable
	Surgical resection only in highly selected individuals - excellent performance status and life expectancy
	Goal is to improve QoL
Prophylactic gastrectomy	Total gastrectomy is essential
	Similar post-operative reduction in QoL as for confirmed malignancy
	Goal is return to pre-operative baseline
	Further studies required

DG: Distal gastrectomy; TG: Total gastrectomy; QoL: Quality of life; GEJ: Gastroesophageal junction.