Abstract
Abstract
Background
The longitudinal recovery process for postoperative quality of life (QOL) after gastrectomy remains incompletely understood. We prospectively evaluated temporal changes in QOL using the Postgastrectomy Syndrome Assessment Scale-45 (PGSAS-45) and investigated predictors of poor postoperative QOL.
Methods
This prospective observational study enrolled 433 patients who underwent gastrectomy for primary gastric cancer between 2015 and 2020. Patients completed the PGSAS-45 questionnaire preoperatively and at 1 month, 6 months, 1 year, and > 5 years after surgery. Longitudinal changes in QOL were analyzed, and multivariable logistic regression was performed to identify predictors of poor postoperative QOL at 1 year after surgery.
Results
All PGSAS-45 domains except the mental component summary (MCS) were significantly deteriorated at 1 month after surgery. Most domains recovered substantially between 1 and 6 months and changed little thereafter. MCS was the only domain that improved beyond the preoperative level. Independent predictors of poor total symptom score were major postoperative complications (Clavien–Dindo grade ≥ III; odds ratio [OR] 4.78,
p
= 0.013) and preoperative MCS p
= 0.001). Preoperative physical component summary (PCS) p
= 0.028) independently predicted poor quality of ingestion, while preoperative MCS p
Conclusions
Postoperative QOL recovered predominantly within the first 6 months after gastrectomy and remained largely stable thereafter. Preoperative PCS and MCS, together with major postoperative complications, were important determinants of postoperative QOL.