Postoperative quality of life and nutritional outcomes following subtotal, proximal, or distal gastrectomy for upper gastric cancer: a retrospective cohort study

PURPOSE: The optimal surgical approach for upper gastric cancer remains controversial, particularly regarding the postoperative quality of life (QOL) and nutritional outcomes. This study compared the outcomes of subtotal gastrectomy (STG), proximal gastrectomy (PG), and distal gastrectomy (DG). METHODS: We retrospectively analyzed 94 patients who underwent gastrectomy for upper gastric cancer (DG: n = 39, PG: n = 33, STG: n = 22). The quality of life (QOL) was assessed using the Postgastrectomy Syndrome Assessment Scale (PGSAS-45) 12 months postoperatively. The nutritional status was evaluated based on changes in body weight. RESULTS: The baseline clinicopathological factors and TNM stages were comparable among the three cohorts. PG was associated with significantly worse reflux, dyspepsia, and meal-related complaints than STG and DG. The STG showed fewer dumping-related symptoms than the PG. No significant differences in overall nutritional status were observed between the STG and DG groups, whereas the PG group tended to be associated with less favorable nutritional outcomes. These findings were consistent with the responder analyses. CONCLUSIONS: In this retrospective cohort study, STG was associated with a more favorable postoperative symptom profile than PG and showed postoperative outcomes comparable to those of DG.