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

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 Supervisors: Camila Dias and Mário Dinis Ribeiro 1st year, Class 17 [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

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. Supervisors: Camila Dias and Mário Dinis Ribeiro 1st year, Class 17 http://plan1998.cancer.gov/PRGRES.htm http://plan1998.cancer.gov/PRGRES.htm (National Cancer Institute) GASTRIC CANCER IN CANCER DEATH RATE (1973-92) 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

4. 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 [2]Schipper H, Clinch J, Olweny LM. Definitions and conceptual issues. Spilker B Philadelphia: Lippincott-Raven, 1996 [3]Qualitty of life Research Unit, University of Toronto, www.gdrc.org/uem/qol-define.html. Introduction Assessment of post-operative quality of life in gastric cancer Supervisors: Camila Dias and Mário Dinis Ribeiro 1st year, Class 17

5. Assess and summarize QoL in patients submitted to surgery for gastric cancer Clarifying validity of the instruments used Objectives Assessment of post-operative quality of life in gastric cancer Supervisors: Camila Dias and Mário Dinis Ribeiro 1st year, Class 17

6. Methods Assessment of post-operative quality of life in gastric cancer Supervisors: Camila Dias and Mário Dinis Ribeiro 1st year, Class 17 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 Publication Date: from 1950 to September 2005 Only items with abstracts

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

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

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

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