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Long-Term Quality of Life After Total Gastrectomy Versus Ivor Lewis Esophagectomy.
- Source :
-
World journal of surgery [World J Surg] 2020 Mar; Vol. 44 (3), pp. 838-848. - Publication Year :
- 2020
-
Abstract
- Background: There is scarce evidence on whether a total gastrectomy or an Ivor Lewis esophagectomy is preferred for gastroesophageal junction (GEJ) cancers regarding effects on morbidity, pathology, survival and health-related quality of life (HR-QoL). The aim of this study was to investigate the difference in long-term HR-QoL in patients undergoing total gastrectomy versus Ivor Lewis esophagectomy in a tertiary referral center.<br />Methods: Patients with a follow-up of >1 year after a total gastrectomy or an Ivor Lewis esophagectomy for GEJ/cardia carcinoma completed the EORTC QLQ-C30 and EORTC QLQ-OG25 questionnaires. 'Problems with eating,' 'reflux,' and 'nausea and vomiting' were the primary HR-QoL endpoints. The secondary endpoints were the remaining HR-QoL domains, postoperative complications and pathology results.<br />Results: Thirty patients after gastrectomy and 71 after esophagectomy were included. Mean age was 63 years. Median follow-up was 2 years (range 12-84 months). Patients after gastrectomy reported less 'choking when swallowing' and 'coughing' (β = - 5.952, 95% CI - 9.437 to - 2.466; β = - 13.084, 95% CI - 18.525 to - 7.643). More lymph nodes were resected in esophagectomy group (p = 0.008). No difference was found in number of positive lymph nodes, R0 resection or postoperative complications.<br />Conclusions: After a follow-up of >1 year 'choking when swallowing' and 'coughing' were less common after a total gastrectomy. No differences were found in postoperative complications or radicality of surgery. Based on this study, no general preference can be given to either of the procedures for GEJ cancer. These results support shared decision making when a choice between the two treatment options is possible.
- Subjects :
- Adult
Aged
Aged, 80 and over
Esophageal Neoplasms psychology
Esophagectomy adverse effects
Female
Gastrectomy adverse effects
Humans
Male
Middle Aged
Postoperative Complications etiology
Stomach Neoplasms psychology
Esophageal Neoplasms surgery
Esophagectomy methods
Esophagogastric Junction surgery
Gastrectomy methods
Quality of Life
Stomach Neoplasms surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1432-2323
- Volume :
- 44
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- World journal of surgery
- Publication Type :
- Academic Journal
- Accession number :
- 31732762
- Full Text :
- https://doi.org/10.1007/s00268-019-05281-8