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Background <p>Long-term quality of life (QoL) for U.S. gastrectomy cancer patients is not well-defined. This study evaluated QoL, financial toxicity, and decision regret &gt; 3 years after gastrectomy.</p> Methods <p>A cross-sectional paper survey using SF-8, Postgastrectomy Syndrome Assessment Scale, COmprehensive Score for financial Toxicity (COST), and Decision Regret Scale (DRS) was administered to adults who underwent therapeutic or prophylactic gastrectomy from 2010 to 2020.</p> Results <p>Of 240 survivors, 117 responded (48.8% response rate). Median age at survey was 68; 57% were male. Median time from surgery to survey was 7.6 years. 30% were prophylactic. Resections were 62% total and 38% partial with half performed minimally invasive. SF-8 physical and mental component scores were comparable to population norms. Highest severity symptom subscales were meal-related distress, dumping, and diarrhea. Total gastrectomy had worse total symptom score (median 1.98 vs. 1.65, <i>p</i> = 0.021) than partial gastrectomy. Dissatisfaction was highest for eating limitations. Median COST score was 33/44 (absent financial toxicity). Gastrectomy affecting employment was reported in 26% with worse associated COST scores (median 26 vs. 34, <i>p</i> = 0.002). Median DRS score was 0/100 with 15% reporting moderate-to-high regret. Regret was not associated with prophylactic gastrectomy, operative approach, complications, or recurrence, however correlated with dissatisfaction (<i>p</i> &lt; 0.001), total symptom burden (<i>p</i> = 0.008), and financial toxicity (<i>p</i> = 0.002). On multivariable analysis, dissatisfaction was the only significant association (<i>p</i> = 0.005).</p> Conclusions <p>Gastrectomy regret was associated with dissatisfaction rather than surgical/oncologic factors. Higher symptom burden in total gastrectomy highlights the surgical implications of improved reconstruction techniques and preserving gastric remnant, when possible, on long-term QoL.</p>

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Long-term quality of life, financial toxicity, and decision regret following therapeutic and prophylactic gastrectomy for cancer

  • 期刊论文

  • 发表日期：

    2026年3月7日

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  • Frank G. Lee,
  • Jack W. Sample,
  • Chun Fan,
  • Robert A. Vierkant,
  • Sara K. Daniel,
  • Steven Bowers,
  • Nabil Wasif,
  • Mark J. Truty,
  • Michael L. Kendrick,
  • Cornelius A. Thiels,
  • Travis E. Grotz

摘要

Background

Long-term quality of life (QoL) for U.S. gastrectomy cancer patients is not well-defined. This study evaluated QoL, financial toxicity, and decision regret > 3 years after gastrectomy.

Methods

A cross-sectional paper survey using SF-8, Postgastrectomy Syndrome Assessment Scale, COmprehensive Score for financial Toxicity (COST), and Decision Regret Scale (DRS) was administered to adults who underwent therapeutic or prophylactic gastrectomy from 2010 to 2020.

Results

Of 240 survivors, 117 responded (48.8% response rate). Median age at survey was 68; 57% were male. Median time from surgery to survey was 7.6 years. 30% were prophylactic. Resections were 62% total and 38% partial with half performed minimally invasive. SF-8 physical and mental component scores were comparable to population norms. Highest severity symptom subscales were meal-related distress, dumping, and diarrhea. Total gastrectomy had worse total symptom score (median 1.98 vs. 1.65, p = 0.021) than partial gastrectomy. Dissatisfaction was highest for eating limitations. Median COST score was 33/44 (absent financial toxicity). Gastrectomy affecting employment was reported in 26% with worse associated COST scores (median 26 vs. 34, p = 0.002). Median DRS score was 0/100 with 15% reporting moderate-to-high regret. Regret was not associated with prophylactic gastrectomy, operative approach, complications, or recurrence, however correlated with dissatisfaction (p < 0.001), total symptom burden (p = 0.008), and financial toxicity (p = 0.002). On multivariable analysis, dissatisfaction was the only significant association (p = 0.005).

Conclusions

Gastrectomy regret was associated with dissatisfaction rather than surgical/oncologic factors. Higher symptom burden in total gastrectomy highlights the surgical implications of improved reconstruction techniques and preserving gastric remnant, when possible, on long-term QoL.