Assessment of post-operative quality of life in gastric cancer:

1

• Assessment of post-operative quality of life in
  gastric cancer
• a systematic review

Ana Rita Marques Natália Ferreira Mylene Costa
Paula Joana Moreira Paula Campelo Paulo
Leandro Pedro Barbosa Pedro Mendes
Supervisors Camila Dias and Mário Dinis Ribeiro
1st
year, Class 17 FMUP/ Serviço de Bioestatística e
Informática Médica
2
Introduction
Assessment of post-operative quality of life in
gastric cancer

• Meta-analysis, a final step in a systematic
  review
• () statistical pooling of data across studies
  to generate summary estimates of effects .() the
  term effect refers to any measure of
  association between exposure and outcome 1
• Meta-analysis is a statistical procedure that
  integrates the results of several independent
  studies considered to be combinable.
• Huke MF, 1988

1 Pai M, McCulloch M, Gordan JD, Pai N,
Enanoria W, Kennedy G, Tharyan P, Colford,Jr JM.
Systematic reviews and meta-analyses An
illustrated, step-by-step guide The National
Medical Journal of India Vol.17 No.2,2004
Supervisors Camila Dias and Mário Dinis Ribeiro
1st
year, Class 17
3
Introduction
Assessment of post-operative quality of life in
gastric cancer

• Gastric cancer as
• A malignant cell growth
• Second leading cause of cancer deaths worldwide
• Surgery as the major way for treatment
• Subtotal gastrectomy
• Total gastrectomy
• Rate of surviving is increasing
• Quality of life (QoL) is then particularly
  important in health care.

GASTRIC CANCER IN CANCER DEATH RATE (1973-92)
http//plan1998.cancer.gov/PRGRES.htm (National
Cancer Institute)
Kaptein AA, Morita S, Sakamoto J. Quality of life
in gastric cancer World J Gastroenterol
2005 http//massgeneral.org/cancer/about/providers
/surgical/gastric.asp
Supervisors Camila Dias and Mário Dinis Ribeiro
1st
year, Class 17
4
Assessment of post-operative quality of life in
gastric cancer
Introduction

• Quality of life (QoL)
• The functional effect of an illness and its
  consequent therapy upon a patient, as perceived
  by the patient. 2
• The degree to which a person enjoys the
  important possibilities of his or her life. 3
• Instruments for studying QoL
• Questionnaires
• Interviews
• 2Schipper H, Clinch J, Olweny LM. Definitions
  and conceptual issues. Spilker B Philadelphia
  Lippincott-Raven, 1996
• 3Qualitty of life Research Unit, University of
  Toronto, www.gdrc.org/uem/qol-define.html.

Supervisors Camila Dias and Mário Dinis Ribeiro
1st
year, Class 17
5
Assessment of post-operative quality of life in
gastric cancer
Objectives

• Assess and summarize QoL in patients submitted to
  surgery for gastric cancer
• Clarifying validity of the instruments used

Supervisors Camila Dias and Mário Dinis Ribeiro
1st
year, Class 17
6
Assessment of post-operative quality of life in
gastric cancer

• Inclusion criteria
• Include a population with gastric cancer that
  have been submitted to a gastrectomy
• Include post-surgery QoL evaluation
• MESH (Medical Subject Headings) terms
• Quality of life
• Gastrectomy
• Stomach neoplasm
• Limits of the research
• Language English, French, Spanish and Italian
• Humans

Methods

Supervisors Camila Dias and Mário Dinis Ribeiro
1st
year, Class 17
7
Assessment of post-operative quality of life in
gastric cancer
Methods

• Exclusion criteria
• Title
• Refer to radiotherapy / chemotherapy
• Not refer specifically to gastric cancer
• Abstract
• Not have abstracts
• Not refer to QoL
• If there is only one case in study
• Not refer to a post-operative instrument
  (questionnaire)
• Not approach QoL in a generic view
• If patients have more than one type of cancer
  besides gastric cancer
• All text
• If we could not have access to the manuscript

Supervisors Camila Dias and Mário Dinis Ribeiro
1st
year, Class 17
8
Assessment of post-operative quality of life in
gastric cancer
Methods Query's Definition

• Quality of life MESH AND (stomach neoplasm
  MESH OR Gastric cancer OR stomach carcinoma)
  NOT intestinal cancer AND (gastrectomy MESH OR
  gastric surgery) NOT chemotherapy (175)
• With limits
• English and humans and within the defined
  publication date and with abstracts 109
  articles
• Italian and humans and within the defined
  publication date and with abstracts 4 articles
• (Surgical treatment OR gastrectomy OR surgery)
  AND (gastric carcinoma OR gastric cancer OR
  stomach neoplasm OR stomach cancer) AND quality
  of life MESH AND questionnaires(42)
• With limits
• Humans and within the defined publication date
  42 articles
• English and humans and within the defined
  publication date 32 articles
• Gastric cancer MESH AND surgery MESH AND
  quality of life MESH AND carcinoma MESH AND
  neoplasm MESH (51)
• With limits
• English and humans 33 articles
• English and humans and within the defined
  publication date 33 articles

Supervisors Camila Dias and Mário Dinis Ribeiro
1st
year, Class 17
9
Assessment of post-operative quality of life in
gastric cancer
Methods Flow chart

Supervisors Camila Dias and Mário Dinis Ribeiro
1st
year, Class 17
10
Assessment of post-operative quality of life in
gastric cancer
Expected results

• 61 included articles
• QoL after gastric cancer surgery lower than QoL
  of the general population
• Different values of QoL between patients
  submitted to total gastrectomy and sub-total
  gastrectomy
• View Gantt Map

Possible heterogeneity
Supervisors Camila Dias and Mário Dinis Ribeiro
1st
year, Class 17