LETTER TO Quality of Life After Gastrectomy for Adenocarcinoma: A Prospective Cohort Study To the Editor: e read with extreme interest the innovative article published by Karanicolas et al1 about the quality of life after distal gastrectomy, proximal gastrectomy, and total gastrectomy. These colleagues have undoubtedly given important contributions to scientific literature in this surgical field and this article shows new results that advance our understanding in gastric surgery. We would like to offer our additional remark from a prospective point of view, pointing out some important elements to consider. The authors are to be commended for their aim to conduct a prospective cohort study to assess the impact of surgical gastric resection on the quality of life of a large group of patients (N ¼ 134).
W
THE
EDITOR
We agree with the authors that in the past the quality of life (QOL) evaluation has often been assessed without a baseline QOL measurement; in so doing, there was a related difficulty in the assessment of the real impact of gastric resection on the QOL without any information about the underlying pathological process. Moreover, it is true that none of the previous studies on the topic had a QOL assessment related to clinically meaningful anchors. However, even if the statistical tests used are correct and the effect to be measured does not have any validated statistical landmark, there seems to be a study design unclear point. In every prospective study if statistical tests are used, their power should be determined a priori. In fact, our main concern is that it is not totally clear how the authors had performed the pre hoc sample size calculation before undertaking this experimental study. Although this study is innovative and important, an accurate experimental design is the only way to draw adequate conclusions about experimental findings. Finally, we would like to again thank the authors for their interesting paper.
Alberto Mangano, MD Stefano Rausei, MD, PhD Department of Surgical Sciences and Human Morphology 1st Division of General Surgery Insubria University, Varese-Como Varese, Italy [email protected] Georgios D. Lianos, MD Department of Surgery Ioannina University School of Medicine Ioannina, Greece Gianlorenzo Dionigi, MD, FACS Department of Surgical Sciences and Human Morphology 1st Division of General Surgery Insubria University, Varese-Como Varese, Italy
REFERENCE 1. Karanicolas PJ, Graham D, Gonen M, et al. Quality of life after gastrectomy for adenocarcinoma: a prospective cohort study. Ann Surg. 2013;257:1039–1046.
Disclosure: The authors declare no conflicts of interest. Copyright ß 2015 Wolters Kluwer Health, Inc. All rights reserved. ISSN: 0003-4932/14/26105-0821 DOI: 10.1097/SLA.0000000000000696
e110 | www.annalsofsurgery.com
Annals of Surgery Volume 262, Number 6, December 2015
Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
W
THE
EDITOR
We agree with the authors that in the past the quality of life (QOL) evaluation has often been assessed without a baseline QOL measurement; in so doing, there was a related difficulty in the assessment of the real impact of gastric resection on the QOL without any information about the underlying pathological process. Moreover, it is true that none of the previous studies on the topic had a QOL assessment related to clinically meaningful anchors. However, even if the statistical tests used are correct and the effect to be measured does not have any validated statistical landmark, there seems to be a study design unclear point. In every prospective study if statistical tests are used, their power should be determined a priori. In fact, our main concern is that it is not totally clear how the authors had performed the pre hoc sample size calculation before undertaking this experimental study. Although this study is innovative and important, an accurate experimental design is the only way to draw adequate conclusions about experimental findings. Finally, we would like to again thank the authors for their interesting paper.
Alberto Mangano, MD Stefano Rausei, MD, PhD Department of Surgical Sciences and Human Morphology 1st Division of General Surgery Insubria University, Varese-Como Varese, Italy [email protected] Georgios D. Lianos, MD Department of Surgery Ioannina University School of Medicine Ioannina, Greece Gianlorenzo Dionigi, MD, FACS Department of Surgical Sciences and Human Morphology 1st Division of General Surgery Insubria University, Varese-Como Varese, Italy
REFERENCE 1. Karanicolas PJ, Graham D, Gonen M, et al. Quality of life after gastrectomy for adenocarcinoma: a prospective cohort study. Ann Surg. 2013;257:1039–1046.
Disclosure: The authors declare no conflicts of interest. Copyright ß 2015 Wolters Kluwer Health, Inc. All rights reserved. ISSN: 0003-4932/14/26105-0821 DOI: 10.1097/SLA.0000000000000696
e110 | www.annalsofsurgery.com
Annals of Surgery Volume 262, Number 6, December 2015
Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
