Quality of life of older rectal cancer patients is not impaired by a permanent stoma

Orsini, R.G.; Thong, Melissa S. Y.; Poll‐Franse, Lonneke V. van de; Slooter, Gerrit D.; Nieuwenhuijzen, Grard A. P.; Rutten, H.J.T.; Hingh, Ignace H. J. T. de

doi:10.1016/j.ejso.2012.10.005

Cited by 63 publications

(58 citation statements)

References 23 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: 77%

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: 77%

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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“…5,11,[27][28][29][30] our study showed that the patients <70 years undergoing tme surgery had significantly better postoperative sexual function and less male sexual dysfunction compared with patients ≥70 years, regardless of treatment. 5,11,[27][28][29][30] our study showed that the patients <70 years undergoing tme surgery had significantly better postoperative sexual function and less male sexual dysfunction compared with patients ≥70 years, regardless of treatment.…”

Section: Discussionmentioning

confidence: 94%

Does Extended Surgery Influence Health-Related Quality of Life in Patients With Rectal Cancer?

Orsini¹,

Vermeer²,

Traa

et al. 2015

Diseases of the Colon &Amp; Rectum

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This study showed no major differences between patients undergoing total mesorectal excision surgery and those receiving extended surgery, with the exception of body image, which was significantly lower in patients <70 years undergoing extended surgery. In all patient groups, treatment for rectal cancer influenced sexual activity dramatically. Awareness of the impact of surgery on health-related quality of life and sexuality is needed.

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“…Thus, our findings related to sex and time since surgery do not directly contradict comparative studies using disease-specific HRQOL measures that have found, for example, that women and survivors with ostomies have worse HRQOL outcomes in certain domains or that the effect of an ostomy on HRQOL is attenuated by increased age. 9,28 …”

Section: Discussionmentioning

confidence: 99%

Greatest Challenges of Rectal Cancer Survivors: Results of a Population-Based Survey

McMullen

Bulkley

Altschuler

et al. 2016

Diseases of the Colon &Amp; Rectum

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Background Eliciting cancer survivors’ priorities is essential to address the specific needs of cancer survivor subgroups. Objective To describe long-term rectal cancer survivors’ greatest challenges related to treatment. Design Observational study with cross-sectional survey. Setting Members of Kaiser Permanente, Northern California and Northwest health plans. Patients A survey was mailed to long-term (≥5 years post diagnosis) rectal cancer survivors who had an anastomosis, temporary ostomy, or permanent ostomy. Main Outcome Measures An open-ended question about the greatest challenge related to cancer surgery. We categorized responses using a grounded theory approach with double coding for reliability. Bonferroni-adjusted X2 values were used to assess differences in the proportions of subgroups who mentioned challenges within each response category. Results The survey completion rate was 61% (577/953); 76% (440/577) of participants responded to the greatest challenge question. Respondents’ greatest challenges were bowel/ostomy management (reported by 44%), negative psychosocial effects (37%), late effects of treatment (21%), comorbidities and aging (13%), postoperative recovery (5%), and negative health care experiences (5%). Survivors with temporary ostomy or anastomosis were more likely than survivors with permanent ostomy to report late effects (p<0.0001 and p=0.01, respectively). Survivors with anastomosis were less likely than survivors with permanent ostomy to report negative psychosocial impacts (p=0.0001). Conclusions Our results reveal the need for bowel/ostomy management, psychosocial services and surveillance for late effects in survivorship and supportive care services for all rectal cancer survivors, regardless of ostomy status. The perspective of long-term survivors with anastomosis reveals challenges that may not be anticipated during treatment decision-making. Limitations Generalizability is restricted by the lack of ethnically and racially diverse, uninsured (non-Medicare-eligible population), and non-English-speaking participants. Because the survey was cross-sectional and included respondents at different times since diagnosis, we could not adequately address changes in the greatest challenges over time.

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Quality of life of older rectal cancer patients is not impaired by a permanent stoma

Cited by 63 publications

References 23 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

Does Extended Surgery Influence Health-Related Quality of Life in Patients With Rectal Cancer?

Greatest Challenges of Rectal Cancer Survivors: Results of a Population-Based Survey

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