Influence of the centralizing gastric cancer surgery on the health-related quality of life in Brazil

Rodrigo Nascimento Pinheiro; Samantha Mucci; Renato Morato Zanatto; Olavo Magalhães Picanço Junior; Augusto Angelo Granado Bottino; Renata Pereira Fontoura; Gaspar de Jesus Lopes Filho

doi:10.21037/jgo-22-1114

Influence of the centralizing gastric cancer surgery on the health-related quality of life in Brazil

J Gastrointest Oncol. 2023 Jun 30;14(3):1235-1249. doi: 10.21037/jgo-22-1114. Epub 2023 Jun 27.

Authors

Rodrigo Nascimento Pinheiro^{1

2}, Samantha Mucci^{1

3}, Renato Morato Zanatto^{1

4}, Olavo Magalhães Picanço Junior⁵, Augusto Angelo Granado Bottino⁴, Renata Pereira Fontoura², Gaspar de Jesus Lopes Filho¹

Affiliations

¹ Interdisciplinary Surgical Science Postgraduate Program, Paulista School of Medicine, Federal University of São Paulo, São Paulo, Brazil.
² Surgical Oncology, Base Hospital of the Federal District, Brasília, Federal District, Brazil.
³ Department of Psychiatry, Paulista School of Medicine, Federal University of São Paulo, São Paulo, Brazil.
⁴ Surgical Oncology, Amaral Carvalho Cancer Hospital, Jaú, São Paulo, Brazil.
⁵ Surgical Oncology, Hospital de Clínicas Alberto Lima, Universidade Federal do Amapá, Macapá, Amapá, Brazil.

Abstract

Background: The assessment of health-related quality of life (QoL) has improved the treatment of gastric cancer. Aiming to compare the influence of skilled surgeons in general hospitals versus specialized hospitals in cancer in Brazil, this study evaluated the relationship between quality of life and types of hospitals (general or cancer) in treating patients with gastric adenocarcinoma operated by surgeons with specific training in Surgical Oncology.

Methods: This was a cross-sectional study involving 104 patients. Inferential analyses were used to compare two Brazilian general hospitals and a cancer center, evaluating scores of the SF-36 and FACT-Ga QoL questionnaires (Kruskal-Wallis test, Mann-Whitney test); gender, smoking, and Helicobacter pylori tests status (Pearson's Chi-Square test); ethnicity, alcoholism, location of the tumor in the stomach, Lauren's histological types, and type of surgery (Fisher's exact test), number of lymph nodes resected by Surgical Oncologists [Analysis of Variance (ANOVA) with a Fixed Factor], and comparative survival analysis (Log-Rank test).

Results: Patients treated at a cancer hospital had higher scores of the FACT-Ga (FACT-G total score, P=0.023; physical well-being, PWB, P=0.006; and functional well-being, FWB, P=0.011). The mean scores of the SF-36 questionnaire showed similar behavior but without reaching a significant difference. Patients operated by Surgical Oncologists at the cancer hospital had better scores in emotional well-being FACT-Ga domain (EWB, P=0.034 and P=0.047) compared to those operated by Surgical Oncologists in general hospitals. There was no significant difference in survival among the three hospitals (P=0.214).

Conclusions: In this study, it was possible to suggest the relationship between QoL assessment scores with the centralization of care at specialized cancer hospital in the treatment of patients with gastric adenocarcinoma undergoing surgery with curative intent in Brazil.

Keywords: Gastrectomy; gastric cancer; gastric neoplasms; quality of life; stomach cancer; stomach neoplasms.