A comparison of postoperative quality of life after open and laparoscopic gastrectomy for early gastric cancer: A multicenter, nonrandomized, controlled study (CCOG 0802).

Abstract

4088 Background: The aim of this study was to compare the postoperative health-related quality of life (HRQoL) between open and laparoscopic distal gastrectomy. Methods: A multi-institutional non-randomized study was conducted, and early gastric cancer patients were prospectively enrolled and underwent distal gastrectomy either by the open or laparoscopic approach. HRQoL was measured using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Cancer (QLQ-C30) and the site-specific module for gastric cancer (QLQ-STO22). Questionnaires were completed at baseline and at 1, 3, 6 and 12 months postoperatively. Clinicopathological characteristics and short term outcome including postoperative morbidity and HRQoL were compared between the approaches. Results: A total of 159 patients with clinical T1 tumors were enrolled between September 2008 and January 2011. Those who were found upon pathologic examination to have ≥aStage II disease (n=14) were excluded, and the remaining 145 patients (open: n=72, laparoscopic: n=73) were analyzed. There were no significant differences between the two groups regarding age, gender, macroscopic type, depth of invasion, lymph node metastasis, and pathologic type. Laparoscopic approach was associated with longer operating time, smaller blood loss, and similar incidence of postoperative complications. At each time point, the questionnaires were sent to the data center from >90% of the patients. The worst scores for most of the items were observed at 1 month postoperatively and improved thereafter. The role, emotional, cognitive, and social functioning scores were superior in the laparoscopic group at 6 and 12 months postoperatively. Symptom scales including fatigue, pain, anxiety, eating restriction, and taste problem were better in the laparoscopic group before 6 months but not at 12 months. Conclusions: Patients treated by the laparoscopic approach benefitted from better HRQoL in terms of symptoms scores during the first 6 months, while the superiority in several functioning scores lasted for 12 months.