Long-term quality of life after open and laparoscopic total gastrectomy for stage I gastric cancer: A prospective multi-institutional study (CCOG1504)

Background

Little information is available from prospective clinical trials on the influences of surgical approaches on postoperative quality of life (QOL). We aimed to prospectively compare chronological changes in postoperative body weight and QOL between laparoscopic and open total gastrectomy for stage I gastric cancer (GC).

Methods

We conducted a multi-institutional prospective study (CCOG1504) of patients who undergo laparoscopic or open total gastrectomy. Body weight was measured at the baseline and at the 1st, 2nd, and 3rd postoperative years (POY). QOL using the European Organization for Research and Treatment of Cancer quality of life questionnaire-C30 (EORTC QLQ-C30) and the Post-Gastrectomy Syndrome Assessment Scale-37 (PGSAS-37) questionnaires were measured at the baseline and at the 1st, 3rd, 6th, 12th, and 36th postoperative months (POM).

Results

We enrolled 84 patients from 15 institutions, and finally 43 patients for the laparoscopic group and 16 for the open group were eligible for data analysis. There were no significant differences in body weight change between the two groups. The role functioning score among the EORTC QLQ-C30 tended to be higher (i.e., better QOL) in the laparoscopic group at POM 1 and 12 after surgery compared to the open group. The dissatisfaction at working score among the PGSAS-37 at 1 month after surgery was lower (i.e. better QOL) in the laparoscopic group compared to the open group.

Conclusions

The results of CCOG1504 indicated that laparoscopic approach for total gastrectomy was associated with a more favorable dissatisfaction at working score (PGSAS-37).