154 Impact of Prophylactic Total Gastrectomy (PTG) on Long-Term Health-Related Quality of Life in Patients with Hereditary Diffuse Gastric Cancer

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Abstract Introduction Hereditary diffuse gastric cancer is predominantly attributed to germline mutation in the CDH1 gene and is associated with a 30-fold increased risk of advanced gastric cancer by the age of 30. Definitive treatment remains PTG but this significantly impacts short-term health-related quality of life (QOL). It is not established if QOL is impaired in the long-term and this study aimed to evaluate this prospectively. Method Prospectively consenting patients undergoing PTG at a national referral centre were included in the familial gastric cancer study between 2005 and 2025. Self-reported QOL data were collected using the validated EORTC QLQ-C30 and QLQ-STO22 questionnaires pre-operatively and at serial post-operative timepoints. Results Both pre-operative and post-operative QOL data were available for 30 patients with follow-up data greater than 5 years in 70%. Symptoms were prevalent in the first 3 months post-op but most recovered by 24 months. Symptoms of diarrhoea, fatigue, appetite loss, reflux and eating difficulties, however, persisted at a level above baseline. Despite these chronic symptoms, physical, social, cognitive and emotional functional domains recovered by 12 months post-operatively and remained stable at baseline levels up to 10 years and beyond. Anxiety symptoms also improved below baseline in long-term follow-up. Conclusions A high prevalence of post-operative symptoms is noted early post-PTG yet many recover to baseline by 2 years. Despite some ongoing symptoms, most patients recover functional levels to baseline by 12 months and this is preserved at >10 years post-op within the context of regular multidisciplinary specialist follow-up.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.