Longitudinal changes and deterioration factors of quality of life after gastrectomy for gastric cancer during first postoperative year

Aim The postoperative quality of life (QOL) has become a major concern with improved survival following gastrectomy for gastric cancer. Although body composition changes dynamically during the first postoperative year, longitudinal changes in the QOL during this period among postgastrectomy cancer patients remain unclear. This study aimed to clarify these changes and the factors influencing QOL deterioration during the first year postgastrectomy. Methods This retrospective observational cohort study included 209 patients who underwent curative gastrectomy for gastric cancer. QOL was assessed preoperatively and at 1, 3, 6, and 12 months postoperatively using the Postgastrectomy Syndrome Assessment Scale-37. Longitudinal changes were analyzed statistically, and predictors of deterioration were identified using multiple regression analysis. Results Most QOL outcome scores, except for diarrhea, were the worst at 1 month postoperatively and then stabilized at 12 months postoperatively. Gastrointestinal and meal-related outcomes, excluding abdominal pain, did not return to preoperative levels. Five distinct temporal patterns were identified. The independent predictors of QOL deterioration were total or proximal gastrectomy, age ≤75 years, sex, body mass index ≥25kg/m 2 , postoperative complications, and adjuvant chemotherapy. Notably, both total and proximal gastrectomies consistently exerted negative effects on meal-related distress, total symptom scores, necessity for additional meals, and dissatisfaction with daily life. Conclusion Postgastrectomy QOL markedly declines in the early period and then gradually improves within 1 year. Regular temporal monitoring and individualized early interventions are warranted to establish a new postoperative management model for improving patient-centered outcomes.