Eun Soo Kim, MD, PhD, from the Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keimyung University School of Medicine, in Daegu, South Korea describes this Original Article, “Comparison of quality of life and worry of cancer recurrence between endoscopic and surgical treatment for early gastric cancer.”
This cross-sectional study with questionnaires aimed to compare the quality of life (QOL), worry of cancer recurrence, and incidence of depression and anxiety in patients who underwent either endoscopic submucosal dissection (ESD) or surgery for early gastric cancer (EGC). ESD has been considered a standard alternative to surgery for the treatment of EGC. Although it is generally presumed that the QOL of patients who have undergone ESD is better than that of patients who have undergone surgery, the effects of ESD on the QOL, worry of cancer recurrence, and mood disorder have not been evaluated.
The current study showed that endoscopic treatment with stomach preservation provided a superior QOL compared with surgical treatment, as demonstrated by a more positive body image and fewer reports of symptoms on the disease-specific and tumor-specific QOL questionnaires. In contrast, patients treated via ESD had a greater degree of concern regarding cancer recurrence than did those treated surgically. Meticulously scheduled endoscopic surveillance and preservation of the whole stomach after ESD may evoke worry of cancer recurrence in patients. There was no difference in the incidence of anxiety and depression between the groups.
Further prospective, randomized, controlled, and longitudinal study is needed to confirm the validity of our findings.
Although stomach preservation increases the risk of developing multiple cancers from the remnant stomach portion, nearly all recurrent lesions found during scheduled endoscopic surveillance are treatable. Endoscopists should address this issue for relieving patient’s concern of cancer recurrence during follow-up period after ESD.
Read the abstract of this article online.
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