Quality of life after surgical treatment of gastric carcinoma

Objective: To see if there was a correlation between self‐assessment and external evaluation of quality of life (QL) after resection of gastric carcinoma, a correlation between overall QL and different components, and the impact of social and medical factors on QL. Design: Prospective study. Setting: University hospital, Germany. Subjects: 71 patients assessed once 12 months after R0‐resection of gastric carcinoma and 35 patients assessed regularly, starting postoperatively. Interventions: QL was assessed by the patients using the European Organisation for Research and Treatment of Cancer (EORTC) core QL questionnaire (QLQ‐C36) and by a psychologist using the Spitzer Index. Main outcome measures: Correlations between self‐assessment and external assessment, between overall scores and single items of QL, and between social and medical factors and QL, as well as changes in QL‐scores during postoperative follow‐up. Results: Self‐assessment and external evaluation of global QL showed a significant but not particularly close correlation ( r = 0.40) and QL was evaluated as better by the external observer using the Spitzer Index. All physical, emotional, and social components of the QLQ‐C36 correlated significantly with patients overall evaluation of QL. Postoperative QL was affected mainly by somatic complaints and physical limitations. Of several factors analysed, tumour recurrence was the decisive factor in deciding patients' QL. Compared with the preoperative assessment, QL had deteriorated on discharge from hospital but was restored during the following six months in patients who remained disease‐free. Conclusion: Compared with the Spitzer Index the QLQ‐C36 differentiates the QL of patients with gastric cancer better and disease‐specific complaints are included. Copyright © 1998 Taylor and Francis Ltd.