24 Background: The aim of this study was to compare the serial changes of health-related quality of life (HRQOL) after Endoscopic submucosal dissection (ESD) with those after surgery in patients with early gastric cancer (EGC). Methods: Gastric cancer patients were prospectively enrolled from 2004 through 2007. HRQOLs of 161 EGC patients were prospectively assessed by European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC-QLQ-C30) and the stomach cancer-specific module EORTC-QLQ-STO22 at the baseline, 1, 6, 12, 18 and 24 months after treatments. Analysis was done using the generalized linear model and paired- ttests. Results: Of 161 patients, 48 (29.8%) underwent ESD (ESD group) and 113 (70.2%) underwent surgery (surgery group). The median age of stomach cancer patients was 57 years. Surgery group had poorer scores compared with those of ESD group in the most HRQOL factors one month after treatments ( P< 0.05), except for emotional and cognitive functioning, financial problems, anxiety, and hair loss. However, most of the functional and symptom scales after surgery subsequently improved and became insignificant until 24 months of follow up. Only 3 parameters including physical functioning, diarrhea and body image in ESD group still remained better until 24 months after treatment ( P< 0.05). Conclusions: Because poorer HRQOLs after surgery in the early post-treatment periods become insignificant during long-term follow-up, surgical treatment should not be discouraged in EGC treatment solely based on the QOL aspects.
The long term effect of metabolic profile and microbiota status in early gastric cancer patients after subtotal gastrectomy
