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. 2022 Feb;125(2):217-226.
doi: 10.1002/jso.26685. Epub 2021 Sep 27.

Evaluating the longitudinal effect of colorectal surgery on health-related quality of life in patients with colorectal cancer

Muriël Reudink  1 , Charlotte J L Molenaar  1 , Cynthia S Bonhof  2   3 , Loes Janssen  1 , Floortje Mols  2   3 , Gerrit D Slooter  1
Affiliations

Evaluating the longitudinal effect of colorectal surgery on health-related quality of life in patients with colorectal cancer

Muriël Reudink et al. J Surg Oncol. 2022 Feb.

Abstract

Background and objectives: Surgery for colorectal cancer (CRC) negatively affects health-related quality of life (HRQoL). Addressing shortcomings in literature, the purpose of this study was to evaluate the impact of surgery for CRC on the course of HRQoL from baseline up to 2 years after diagnosis.

Methods: In this prospective, population-based study patients with newly diagnosed CRC were included between 2016 and 2019. HRQoL was assessed by the EORTC QLQ-C30 questionnaire over time both between and within subgroups of patients that underwent right-sided colonic, left-sided colonic, and rectal resection using linear mixed model analyses.

Results: The study included 415 patients of whom 148 patients underwent right-sided colonic (36%), 147 left-sided colonic (35%), and 120 rectal resection (29%). Overall, HRQoL scores restored to baseline level 1 year after diagnosis. Impact of surgery seems to be more prominent in patients who underwent rectal resection, as they experienced more pain and had worse role and social functioning scores 4 weeks after surgery. Finally, among patients who underwent left-sided and rectal resection, physical functioning did not return to baseline level during follow-up.

Conclusion: This study shows several differences (between-group and within-group) in HRQoL according to surgery type and offers perspective which patients may need additional support in the care pathway.

Keywords: PROFILES; colorectal cancer; colorectal resection; health-related quality of life; recovery; surgery.

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Conflict of interest statement

The authors declare that there are no conflict of interests.

Figures

Figure 1
Figure 1
Flowchart of the study
Figure 2
Figure 2
Health‐related quality of life function scores over time measured with the European Organization for Research and Treatment of Cancer QLQ‐C30 questionnaire for subgroups (right‐sided resection, left‐sided resection, and rectal resection). A higher score means better functioning/global health status. For a more visually suitable display of the results, the scale ranges from 50 to 100. The actual scale ranges from 0 to 100. Between‐group analyses: *significant difference between patients that underwent right‐sided and left‐sided resection. **significant difference between patients that underwent right‐sided and rectal resection. ***significant difference between patients that underwent left‐sided and rectal resection.Within‐group analyses: asignificant difference baseline, 4‐week follow‐up; bsignificant difference baseline, 1‐year follow‐up, csignificant difference baseline, 2‐year follow‐up; dsignificant difference 4‐week, 1‐year follow‐up; esignificant difference 4‐week, 2‐year follow‐up. Analyses were adjusted for: age, time between diagnosis and baseline, number of comorbid conditions, tumor stage, (neo)adjuvant therapy, surgical approach, and stoma
Figure 3
Figure 3
Health‐related quality of life of single items and scales over time measured with the European Organization for Research and Treatment of Cancer QLQ‐C30 questionnaire for subgroups (right‐sided resection, left‐sided resection, and rectal resection). A lower score means less symptoms. For a more visually suitable display of the results, the scale ranges from 0 to 40. The actual scale ranges from 0 to 100. Between‐group analyses: *significant difference between patients that underwent right‐sided and left‐sided resection. **significant difference between patients that underwent right‐sided and rectal resection. ***significant difference between patients that underwent left‐sided and rectal resection. Within‐group analyses: asignificant difference baseline, 4‐week follow‐up; bsignificant difference baseline, 1‐year follow‐up; csignificant difference baseline, 2‐year follow‐up; dsignificant difference 4‐week, 1‐year follow‐up; esignificant difference 4‐week, 2‐year follow‐up. Analyses were adjusted for: age, time between diagnosis and baseline, number of comorbid conditions, tumor stage, (neo)adjuvant therapy, surgical approach, and stoma
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