1 / 23

Assessment of quality of life of patients with gastric cancer after surgery:

Assessment of quality of life of patients with gastric cancer after surgery: a systematic review. Ana Marques; Mylene Costa; Natália Ferreira; Paula Campelo; Paula Moreira; Paulo Leandro; Pedro Barbosa; Pedro Mendes [Class 17 – 1st year ]. Supervisors: Claúdia Dias and Mário Ribeiro MD, PhD

noam
Download Presentation

Assessment of quality of life of patients with gastric cancer after surgery:

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Assessment of quality of life of patients with gastric cancer after surgery: a systematic review Ana Marques; Mylene Costa; Natália Ferreira; Paula Campelo; Paula Moreira; Paulo Leandro; Pedro Barbosa; Pedro Mendes [Class 17 – 1st year] Supervisors: Claúdia Dias and Mário Ribeiro MD, PhD FMUP/ Serviço de Bioestatística e Informática Médica

  2. Introduction • Meta-analysis, a final step in a systematic review: • “(…) statistical pooling of data across studies to generate summary estimates of effects .” [1] • “(…) the term “effect” refers to any measure of association between exposure and outcome” [1] [1] Pai M, The National Medical Journal of India Vol.17 No.2,2004

  3. Introduction • Gastric cancer as: • A malignant cell growth in the stomach; • Second leading cause of cancer deaths worldwide [2]; • Surgery as the major way for treatment [3]: • Distal gastrectomy without or with pylorus preservation; • Total gastrectomy without or with pouch; • Endoscopic mucosal resection or limited resections • Proximal gastrectomy • [2] Plummer M, Epidemiology of gastric cancer IARC Sci Publ. 2004;(157):311-26. • [3] Roukos DH. Ann Surg Oncol. 1999 Jan-Feb;6(1):46-56. Review.

  4. Introduction GASTRIC CANCER IN CANCER DEATH RATE (1973-92) Rate of death is decreasing http://plan1998.cancer.gov/PRGRES.html (National Cancer Institute) Quality of life (QoL) is then particularly important in health care. [4] [4] Kaptein AA, Morita S, Sakamoto J. Quality of life in gastric cancer World J Gastroenterol 2005

  5. Introduction • Quality of life (QoL): • “The functional effect of an illness and its consequent therapy upon a patient, as perceived by the patient.” [5] • “The degree to which a person enjoys the important possibilities of his or her life.” [6] • Instruments for studying QoL: • Questionnaires • Interviews • Physical examination and laboratory tests • [5]Schipper H. Spilker B Philadelphia: Lippincott-Raven, 1996 • [6]Qualitty of life Research Unit, University of Toronto, www.gdrc.org/uem/qol-define.html.

  6. Aims • Clarify reproducibility and validity of the instruments used to assess QoL in studies evaluating patients submitted to surgery for gastric adenocarcinoma. • Summarize QoL in studies using validated questionnaires.

  7. Methods • Type of study: • Systematic review • Target population: • Population with gastric cancer that have been submitted to a gastrectomy; • Inclusion criteria of the articles: • Include a population with gastric cancer that have been submitted to a gastrectomy; • Include post-surgery QoL evaluation; • With abstracts.

  8. Methods Exclusion criteria of the articles: Title: • Refer to radiotherapy / chemotherapy exclusively Abstract: • If there is only one case in study • Not refer to a post-operative instrument • Not approach QoL in a global view • If patients with gastric cancer were part of a large group of patients with various other types of cancer Fullarticle: • Not have access to article • Not describe the patients studied • Not refer QoL assessment • Not have retrievable data

  9. Methods Quality of articles: Consider a valid article if: - describe the patients studied; - refer the stage of disease; - refer the instrument used; - questionnaire is valid.

  10. Methods Articles search • Pubmed • Key words • MESH (Medical Subject Headings)terms: . Quality of life . Gastrectomy . Stomach neoplasm • Limits of the research: Language: English Humans Publication Date: from 1950 to September 2005 Only items with abstracts

  11. Methods : Query's Definition Pubmed ("Quality of Life" [MeSH] OR quality of life) AND ("Stomach Neoplasms" [MeSH] OR stomach neoplasms OR gastric cancer OR stomach carcinoma) NOT intestinal cancer AND ("Gastrectomy" [MeSH] OR gastrectomy OR gastric surgery) NOT chemotherapy NOT radiotherapy 173 articles found

  12. Methods 2. Scopus Limits of the research: - year: until 2005; - areas: "health" e "life sciences"; - document type: "review" e "article" Query´s definition: TITLE-ABS-KEY("Quality of life") AND TITLE-ABS-KEY(("stomach neoplasms") OR ("gastric cancer") OR ("stomach carcinoma")) AND NOT (intestinal cancer) AND TITLE-ABS-KEY(("gastrectomy") OR ("gastric surgery")) AND NOT (chemotherapy) AND NOT (radiotherapy) 189 articles found

  13. Articles reached 173 + 189 = 362 362 - 102 (found in both searches) = 260 87 71

  14. Methods : Flow chart

  15. Methods - Extracted data Extracted data: - Geographical setting - Characteristics of patients: - stage of disease at diagnosis - Number of patients studied - Questionnaires - Type of surgery - Timing of assessment of QoL

  16. Validated questionnaires Non-validated questionnaires Results - Description of questionnaires: validation

  17. Results - Description of questionnaires: validation • Validity of the instruments used • We found 40 different questionnaires. • Only a minor part of them were validated (18%). • There was a great a number of single time used questionnaires (19). • In the 5 included articles were represented only 2 kinds of questionnaires: EORTC QLQ-C30 and Gastrointestinal QoL Index.

  18. Results Description of questionnaires: main characteristics

  19. Results Summary of QoL in validated questionaires

  20. Conclusions Clarify reproducibility and validity of the instruments used to assess QoL in studies evaluating patients submitted to surgery for gastric adenocarcinoma. • There is a great diversity of questionnaires used to assess QoL after surgery for gastric cancer; • Most studies use questionnaires that were not previously validated (82%). • The same questionnaire is used across different studies rarely.

  21. Conclusions Summarize QoL in studies using validated questionnaires. • A summary pooled result for QoL after surgery for gastric adenocarcinoma was not possible to obtain. • Nevertheless, by observing the preoperative values, we can conjecture the existence of a slight decreasing of QoL after surgery followed by a more or less obvious recovery. • It is possible to see some benefit in the use of a pouch after total gastrectomy. • Further studies would be needed in order to give a more conclusive answer to the questions we raise, preferably using validated EORTC QLQ-C30 or Gastrointestinal QoL Index where the collected data could be fully used in further reviews.

  22. Gantt Chart

  23. Website

More Related