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Observational Study
. 2025 May;34(5):1501-1514.
doi: 10.1007/s11136-025-03918-x. Epub 2025 Feb 18.

Quality of life outcomes in colorectal cancer survivors: insights from an observational study at a tertiary cancer center

Pola Marchewczyk  1 , Beatriz Costeira  2 , Francisca Brito da Silva  1   2 , Daniela Cavadas  1   2 , Nuno Abecasis  2 , Manuel Limbert  1   2 , João Maciel  3   4
Affiliations
Observational Study

Quality of life outcomes in colorectal cancer survivors: insights from an observational study at a tertiary cancer center

Pola Marchewczyk et al. Qual Life Res. 2025 May.

Abstract

Purpose: Colorectal cancer (CRC) significantly impacts the quality of life (QoL) of survivors, yet detailed assessments of long-term QoL are sparse. This study evaluates QoL among CRC survivors, examining the influence of different treatments and patient characteristics on outcomes.

Methods: We conducted a cross-sectional study at a tertiary cancer center in Portugal, enrolling CRC patients who underwent curative surgery from 2013 to 2022. QoL was assessed using the EORTC QLQ-C30 and QLQ-CR29 at 1-, 3-, 5-, and 10-year follow-up intervals. Subgroup analyses were performed based on tumor location, radiotherapy administration, chemotherapy administration, presence of a stoma, and time since treatment, with sociodemographic and clinical factors examined on univariate and multivariate analysis.

Results: Of the 825 eligible patients, 324 were invited and 179 participated (response rate: 55.2%). Overall, patients reported high global QoL and functional scores with low symptom scores, comparable to those of the general population. However, rectal cancer survivors experienced poorer outcomes in role and social functioning, body image, and symptom management. Those receiving radiotherapy or chemotherapy reported more symptoms, with chemotherapy recipients showing lower functional scores. Patients with a stoma had significantly lower QoL across functional and symptom scales. Long-term survivors reported decreased physical functioning. Multivariate analysis identified female gender, open surgery, and chemotherapy as factors associated with reduced QoL.

Conclusion: This study highlights significant disparities in QoL outcomes between CRC survivors, with QoL influenced by gender, cancer location, radiotherapy or chemotherapy, stoma presence, and survivorship duration, underscoring the need for personalized support programs and tailored care plans.

Keywords: Colon cancer; Colorectal cancer; Long-term survivors; Quality of life; Rectal cancer; Stoma.

Plain language summary

People who survive colorectal cancer often face long-lasting health issues that can affect their daily lives. It’s important to understand these challenges so we can find better ways to help them. Our study investigates how different patient characteristics and treatment modalities for colorectal cancer can affect the quality of life afterward. We want to know which of them might make life harder for survivors. The main focus of our research is to see how surgery, radiotherapy, and chemotherapy impact how well survivors can lead their lives, how they feel physically, and their ability to interact socially after cancer. We found that tumor’s location, receiving radiotherapy or chemotherapy, and having a stoma significantly affect life after cancer. For instance, rectal cancer survivors often face harsher quality of life effects than those with colon cancer, particularly in areas like social and role functioning. Furthermore, being a female, undergoing open surgery, and receiving chemotherapy were independently associated to reduced quality of life. These differences underline the importance of considering personal aspects of each patient’s case when planning treatment and support, ensuring that all survivors receive the care and attention they need to improve their overall well-being.

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Conflict of interest statement

Declarations. Conflict of interest: This study did not involve any funding and there are no conflicts of interest to report.

Figures

Fig. 1
Fig. 1
Flow diagram of patients assessed for eligibility and participation in the study
Fig. 2
Fig. 2
(a)Mean global health/QoL and functional scores from the EORTC QLQ-C30 for participants with colorectal cancer compared to mean scores from the general population. (b) Mean symptom scores from the EORTC QLQ-C30 for participants with colorectal cancer compared to mean scores from the general population
See this image and copyright information in PMC

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