Health-Related Quality of Life Outcomes in Disease-Free Survivors of Mid-Low Rectal Cancer After Curative Surgery

Pucciarelli, Salvatore; Bianco, Paola Del; Toppan, Paola; Serpentini, Samantha; Efficace, Fabio; Pasetto, Lara Maria; Friso, Maria Luisa; Salvo, Gian Luca De; Nitti, Donato

doi:10.1245/s10434-008-9923-0

Cited by 51 publications

(61 citation statements)

References 32 publications

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“…Similar results were found in other studies with longitudinal QOL measurements [27][28][29] and confirmed by a systematic review of 23 studies regarding the changes in physical-and role functioning after colorectal cancer treatment [30]. Also, worse postoperative physical functioning in older patients compared to younger patients was described previously [7,[32][33][34][35][36][37]. Our results may add that older patients still report poor physical-, social-, and role functioning up to one year after diagnosis compared to their pretreatment level and compared to the reference population, indicating slow recovery or permanently affected functioning.…”

Section: Discussionsupporting

confidence: 88%

The impact of postoperative complications on health-related quality of life in older patients with rectal cancer; a prospective cohort study

Couwenberg

Beer

Intven

et al. 2018

Journal of Geriatric Oncology

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a b s t r a c t a r t i c l e i n f oObjectives: As result of the aging population and increasing rectal cancer incidence, more older patients undergo treatment for rectal cancer. This study compares treatment course, postoperative complications, and quality of life (QOL) between older and younger patients with rectal cancer and evaluates the impact of postoperative complications on QOL in the elderly. Materials and Methods: Patients with rectal cancer participating in a prospective colorectal cancer cohort and referred for radiotherapy between 2013 and 2016 were included. QOL was assessed with the cancer questionnaire of the European Organisation for Research and Treatment of Cancer (EORTC QLQ-C30) before treatment and at three, six, and twelve months. Outcomes were compared between older patients (≥70 years) and younger patients (b 70 years) and stratified by presence of postoperative complications. Results: In total, 115 (33%) older patients and 230 (67%) younger patients were included. Compared to younger patients, older patients underwent significantly more often short-course radiation with delayed surgery (6.1% and 19.1% respectively) and less often chemoradiation (62.6% and 39.1% respectively), and were more likely to undergo a Hartmann procedure with permanent stoma (3.5% and 13.0% respectively) instead of sphincter-sparing surgery (43.9% and 29.6% respectively). Postoperative complication rates were similar (38.5% in older patients versus 34.7% in younger patients). Older patients had worse physical functioning at six and twelve months after diagnosis compared to younger patients. Presence of postoperative complications had a significant stronger impact on physical-and role functioning in older patients. Conclusion: Older patients undergo more often a tailored treatment approach for rectal cancer than younger patients. With this tailored approach, similar postoperative complication rates and QOL are achieved. However, postoperative complications have a larger negative impact on physical-and role functioning in older patients which indicates a need for better prediction of postoperative complications in the elderly.

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Section: Discussionsupporting

confidence: 88%

The impact of postoperative complications on health-related quality of life in older patients with rectal cancer; a prospective cohort study

Couwenberg

Beer

Intven

et al. 2018

Journal of Geriatric Oncology

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“…Although the mean QoL scores reported within this study are comparable to population norms [3][4][5], pain was significantly associated with poorer SRH and QoL on all subscales. Furthermore, differences in FACT-C scores between those who did and did not report pain are clinically significant, with disparities greater than the minimally important differences suggested by Yost and colleagues [23].…”

Section: Discussionsupporting

confidence: 49%

“…Previous studies concluded that colorectal cancer (CRC) survivors regain quality of life (QoL) of similar or greater levels than those reported by normative populations [3][4][5]. The positive reframing of QoL in the presence of chronic symptoms is a widely discussed and accepted concept within the chronic illness literature [3,6].…”

mentioning

confidence: 99%

“…The positive reframing of QoL in the presence of chronic symptoms is a widely discussed and accepted concept within the chronic illness literature [3,6]. However, it is estimated one third of cancer survivors experience pain following curative cancer treatment [5,[7][8][9][10][11], compared to almost two thirds of those receiving anti-cancer treatment, or living with advanced, metastatic or terminal cancer [7].…”

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confidence: 99%

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The cost of survival: an exploration of colorectal cancer survivors’ experiences of pain

2017

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Background: The Institute of Medicine report 'From Cancer Patient to Cancer Survivor' has drawn widespread attention to the experiences of cancer survivors. Research examining the symptom experiences of survivors are proliferative within the literature but limited by samples which include multiple tumor groups and varying inclusion criteria. This cross-sectional quantitative study seeks to examine pain and quality of life (QoL) in the context of colorectal cancer (CRC) survivorship, as defined by the Institute of Medicine. Material and methods: A purposive sample of CRC survivors (n ¼ 252) attending hospitals and cancer support centers in the Republic of Ireland were recruited between September 2014 and January 2016. Self-rated health (SRH), QoL and pain were assessed in the sample using the EuroQOL questionnaire, the Functional Assessment of Therapy-Colorectal (FACT-C) questionnaire, and symptom experience items. Results: One hundred participants (40%) indicated they had pain on the day of the survey or in the past week. Of those with pain, many also experienced a lack of energy (95%), bowel dysfunction (74%), sleep disturbance (76%) or interference with their ability to enjoy life (75%). Pain was associated with younger age, female gender, current chemotherapy treatment, and previous radiotherapy treatment. Although participants reported positive QoL scores, statistical analysis revealed pain was linked to significantly poorer SRH and overall QoL, and poorer physical, emotional, functional, social/family and CRC-specific wellbeing, compared to those who did not indicate pain. Discussion: Pain was experienced by almost two fifths of CRC survivors up to five years after treatment and was associated with poorer SRH and QoL. In light of these findings, healthcare professionals must endeavor to manage cancer survivors' needs in a manner which is cognizant of the burden of pain and in the context of other symptoms and morbidities experienced by long-term cancer survivors.

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“…Compared to surgery alone, however, this approach is associated with increased male sexual problems, faecal incontinence, and bowel dysfunction, which, in turn, negatively affect the quality of life of patients [3,4].…”

Section: Introductionmentioning

confidence: 99%

Validity and reliability of the MSKCC Bowel Function instrument in a sample of Italian rectal cancer patients

Zotti

Bianco

Serpentini

et al. 2011

European Journal of Surgical Oncology (EJSO)

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AimsThe purpose of this study was to translate the Memorial Sloan Kettering Cancer Centre (MSKCC) Bowel Function Instrument into Italian and to test its psychometric validity and reliability in a sample of Italian rectal cancer patients. MethodsThe MSKCC questionnaire was translated into Italian using a standard procedure of double-back translation. Construct validity was tested using a factor analysis and internal reliability was estimated using the Cronbach's alpha coefficient. Concurrent validity was determined by correlations with European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-CR38 quality of life scales. A non-parametric analysis of variance was used to establish the discriminant validity of the questionnaire. Test-retest reliability was assessed using the intra-class correlation coefficient. Results124 rectal cancer patients participated in the validation study. The number of missing items was 2.2%. The factorial structure was found to be quite similar to the original one and the internal reliability was 0.7 for urgency, 0.6 for frequency, and 0.7 for dietary subscale.The test-retest reliability was acceptable with one exception: the dietary subscale showed a low reproducibility (ICC=0.4). All three subscales showed a significant correlation with the QLQ-C30 and QLQ-CR38 domains and were able to discriminate several groups of clinical relevance. ConclusionsThe Italian version of the MSKCC Bowel Function Instrument shows acceptable psychometric properties and can be considered a valuable and specific instrument to assess bowel functions in rectal cancer patients, both for research purposes and in clinical practice.

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Health-Related Quality of Life Outcomes in Disease-Free Survivors of Mid-Low Rectal Cancer After Curative Surgery

Abstract: Overall, patients with rectal cancer recover well in the long run, with HRQOL levels comparable to that of the general population. HRQOL outcomes provide valuable data that may be used to improve information disclosure to patients.

Cited by 51 publications

References 32 publications

The impact of postoperative complications on health-related quality of life in older patients with rectal cancer; a prospective cohort study

The impact of postoperative complications on health-related quality of life in older patients with rectal cancer; a prospective cohort study

The cost of survival: an exploration of colorectal cancer survivors’ experiences of pain

Validity and reliability of the MSKCC Bowel Function instrument in a sample of Italian rectal cancer patients

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