TY - JOUR
T1 - Prophylactic gastrectomy in CDH1-mutation carriers
T2 - Psychosocial, physical, and nutritional effect compared with curative gastrectomy for gastric cancer
AU - Cats, A
AU - Kluijt, I
AU - Ausems, M
AU - Hartig, A
AU - de Boer, M
AU - van Hillegersberg, R
AU - Plukker, J T
AU - van Riel, E
AU - Sijmons, R
AU - Spruijt, L
AU - Oldenrode-Berends, M
AU - Hoogerbrugge, N
AU - Bleiker, E
PY - 2011
Y1 - 2011
N2 - e14616 Background: Carriers of a CDH1 gene mutation have a risk of up to 80% to develop gastric cancer (GC). Prophylactic total gastrectomy is offered to mutation carriers to prevent invasive GC development. In this usually young and asymptomatic population, however, the psychosocial, physical and nutritional consequences are largely unknown. Therefore, the aim of this study was to investigate the impact of preventive gastrectomy in CDH1 mutation carriers.METHODS: Questionnaires were sent to individuals with a CDH1 gene mutation, who had undergone a prophylactic gastrectomy. Disease-free sporadic GC patients, who had undergone a total gastrectomy 2-5 years earlier also received these questionnaires and served as a comparison group. The questionnaire assessed psychosocial (quality of life [QLQ C30, STO22], anxiety and depression [HADS], social impairment), physical (fatigue [CIS]) and nutritional variables.RESULTS: Of the 21 CDH1 carriers who had a prophylactic gastrectomy, 20 (95%) participated (45% males). Of 23 addressed GC patients, 20 (87%) participated (70% males). Mean age was 41 years (range 20-68 years) and 59 years (range 37-74), respectively. Mean time since gastrectomy was 34 months (SD= 18 months, range 5-63 months) and 47 months (SD= 22 months; range 15-80 months), respectively. The levels of quality of life, anxiety, depression, and fatigue as reported by the two groups (preventive vs. curative resection) did not differ significantly. All together, 48% reported complaints about fatigue (28% had severe fatigue), and 18-48% of the patients reported (severe) impairment in daily activities (work, hobbies, personal relationships). Mean ±SD weight loss of 15% ± 6% was found. Food and drink products that patients were unable to consume were: dairy products (73%), fried products (25%), and soft drinks (13%).CONCLUSIONS: Following total gastrectomy, patients experience fatigue, impairment of everyday life, and weight loss. Patients with a preventive gastrectomy (carriers) did not differ from cancer patients treated by a curative gastrectomy. However, complaints varied widely among participants.
AB - e14616 Background: Carriers of a CDH1 gene mutation have a risk of up to 80% to develop gastric cancer (GC). Prophylactic total gastrectomy is offered to mutation carriers to prevent invasive GC development. In this usually young and asymptomatic population, however, the psychosocial, physical and nutritional consequences are largely unknown. Therefore, the aim of this study was to investigate the impact of preventive gastrectomy in CDH1 mutation carriers.METHODS: Questionnaires were sent to individuals with a CDH1 gene mutation, who had undergone a prophylactic gastrectomy. Disease-free sporadic GC patients, who had undergone a total gastrectomy 2-5 years earlier also received these questionnaires and served as a comparison group. The questionnaire assessed psychosocial (quality of life [QLQ C30, STO22], anxiety and depression [HADS], social impairment), physical (fatigue [CIS]) and nutritional variables.RESULTS: Of the 21 CDH1 carriers who had a prophylactic gastrectomy, 20 (95%) participated (45% males). Of 23 addressed GC patients, 20 (87%) participated (70% males). Mean age was 41 years (range 20-68 years) and 59 years (range 37-74), respectively. Mean time since gastrectomy was 34 months (SD= 18 months, range 5-63 months) and 47 months (SD= 22 months; range 15-80 months), respectively. The levels of quality of life, anxiety, depression, and fatigue as reported by the two groups (preventive vs. curative resection) did not differ significantly. All together, 48% reported complaints about fatigue (28% had severe fatigue), and 18-48% of the patients reported (severe) impairment in daily activities (work, hobbies, personal relationships). Mean ±SD weight loss of 15% ± 6% was found. Food and drink products that patients were unable to consume were: dairy products (73%), fried products (25%), and soft drinks (13%).CONCLUSIONS: Following total gastrectomy, patients experience fatigue, impairment of everyday life, and weight loss. Patients with a preventive gastrectomy (carriers) did not differ from cancer patients treated by a curative gastrectomy. However, complaints varied widely among participants.
M3 - Article
C2 - 28021321
SN - 0732-183X
VL - 29
SP - e14616
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 15_suppl
ER -