• Elizabeth Worster, Xinxue Liu, Susan Richardson, Richard H Hardwick, Sarah Dwerryhouse, Carlos Caldas, and Rebecca C Fitzgerald.
• *MRC Cancer Unit, University of Cambridge, UK †Department of Oncology, Addenbrooke's Hospital, Cambridge, UK ‡Cambridge Oesophago-Gastric Centre, Addenbrooke's Hospital, Cambridge, UK §Cancer Research UK Cambridge Institute, Cambridge, UK.
• Ann. Surg. 2014 Jul 1; 260 (1): 879387-93.

BackgroundThe advice to individuals with identified CDH1 mutations is generally to undertake prophylactic total gastrectomy (PTG). This study evaluated the effect of PTG on health-related quality of life (HRQL) in asymptomatic individuals with identified CDH1 mutations at high risk for gastric cancer.MethodsIndividuals with hereditary diffuse gastric cancer (HDGC) were recruited to a prospective, multicenter UK study. Questionnaires, including the European Organization for Research and Treatment for Cancer core Quality-of-Life Questionnaire (EORTC QLQ C30); the gastric cancer specific module (EORTC QLQ STO22); and the 36-item short form health survey version 2.0, were completed before and at regular intervals after surgery.ResultsSixty individuals fulfilled HDGC criteria; 38 (63%) had a CDH1 mutation and 32 (53%) underwent PTG. At baseline, there was no significant difference in mental health depending on CDH1 mutation status and treatment preference. Physical functioning reduced in the first month after surgery but recovered to baseline by 12 months. Similarly mental functioning reduced in the first month after surgery but recovered by 3 to 9 months. However, specific symptoms were identified, such as diarrhoea (70%), fatigue (63%), discomfort when eating (81%), reflux (63%), eating restrictions (45%), and body image (44%), which persisted after PTG.ConclusionsPatients contemplating prophylactic gastrectomy can be reassured about the long-term HRQL outcomes, but some residual symptoms require adjustment.

25 keywords...

hide…