Predictors of health-related quality of life and association with survival may identify colorectal cancer patients at high risk of poor prognosis

Abstract

Purpose To investigate the mediators of health-related quality of life (HR-QoL) in colorectal cancer (CRC) patients and effect on overall survival. Methods We analyzed baseline (within 1 year of diagnosis) SF-12v1 questionnaire data from 3,734 CRC patients and assessed the differences in mental composite scores (MCS) and physical composite scores (PCS) by socio-demographics and risks of poor HR-QoL by these factors. Hazard ratios were generated using univariate cox regression for MCS and PCS dichotomized using the normalized scoring based mean of 50 and survival estimates generated using the Kaplan-Meier method. Results Differences in MCS and PCS were identified by sex, age, education level, alcohol use, tobacco use, and stage. Race, marital status, and cancer site differed only by PCS. Being female, never married, former alcohol user, or with stage IV disease significantly increased risk of a poor HR-QoL, with magnitudes of risk from 1.25- to 1.97-fold. Higher education level had a protective effect (MCS: Ptrend=2.32×10−7; PCS: Ptrend=5.62×10−14). Hispanics and African-Americans had a 1.35- and 1.57-fold risk of poor PCS, and increase in age had a protective effect for risk of poor MCS (Ptrend=1.84×10−7). Poor MCS or PCS were associated with poor prognosis and decreased survival at 5-years (HRMCS=1.57, 95%CI=1.41–1.76 and HRPCS=2.38, 95%CI=2.08–2.72), and both remained significant when adjusting for age, gender, race, education level, tumor stage, and tumor site. Conclusions Our findings identify potential mediators for HR-QoL and suggest that baseline HR-QoL assessment may be prognostic for CRC.

High symptom burden is associated with impaired quality of life in colorectal cancer patients during chemotherapy:A prospective longitudinal study

“…[170] One might then question whether the term QoL is used correctly in this thesis, even though the SF-12 has been used in other studies to assess HRQoL in CRC patients. [144,164,181] Another limitation is that we scored the PCS and MCS subscales using the 1998 U.S.…”

“…[224] Given the lack of a standardized tool, other PROMs used in studies of CRC patients include the EORTC QoL questionnaires, [143,148,211,225,226] the MSAS, [66,105,200] and SF-12. [144,164,227] However, the use of PROMs in the clinical setting is not useful without follow-up strategies. It is important to use methods that can ensure an easy and quick response to, and management of, symptoms, [14] to allow both patients and their caregivers access to the results.…”

Health-Related Predictors of Quality of Life in Cancer Patients in Saudi Arabia

“…There is evidence that older age has negative effects on the QoL in cancer patients [ 5 , 6 ], while gender has an influence on the degree of QoL impairment [ 7 ]. Lack of education has a negative effect on cancer patients [ 7 ], and low income has also been negatively associated with QoL in cancer patients [ 8 – 11 ]. Other factors contributing to QoL impairment may include clinical presentations of cancer patients such as the stage, type, and site of the cancer [ 7 , 12 ].…”

When do defecation function and quality of life recover for patients with non-ostomy and ostomy surgery of rectal cancer?

“…He illustrated that patients' global health, QOL, EF, and physical function begin to improve in the third month, and that it takes 2 years for the nausea and vomiting, agrypnia, constipation, and diarrhea scores to revert to baseline values. Reyes et al [22] found significant differences in health-related quality of life (HR-QOL) among racial groups, with African-Americans showing the worst HR-QOL, which was measured using physical and mental composite scores. Our study demonstrated that there was no significant difference in sex, age, preoperative CRP levels, maximum tumor diameter, bowel resection length, TNM stage, tumor differentiation, and chemotherapy between the two groups, although surgical method, TD, and AD differed.…”