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. 2025 Mar 31;151(4):127.
doi: 10.1007/s00432-025-06186-x.

Pain and overall quality of life in palliatively treated colorectal cancer patients 1 year after diagnosis- results from the EDIUM cohort

Sophie Klara Schellack  1 , Clara Breidenbach  1 , Christoph Kowalski  1 , Ulrich Wedding  2 , Birgitt van Oorschot  3 , Thomas Seufferlein  4 , Stefan Benz  5 , Martin Schnell  6 , Jörg Köninger  7 , Christina Klein  8 , Johann Ockenga  9 , Björn Freitag  10 , Uwe A Wittel  11 , Roger Wahba  12 , Mia Kim  13 , Saleem Elhabash  14 , Pompiliu Piso  15 , Dirk Weyhe  16 , Jörg Bunse  17 , Maren Riechmann  18 , Marco von Strauss  19 , Sebastian Petzoldt  20 , Philipp-Alexander Neumann  21 , Vanessa Kolb  22 , Nora Tabea Sibert  23   24
Affiliations

Pain and overall quality of life in palliatively treated colorectal cancer patients 1 year after diagnosis- results from the EDIUM cohort

Sophie Klara Schellack et al. J Cancer Res Clin Oncol. .

Abstract

Purpose: Diagnosis with UICC stage IV colorectal cancer often indicates palliative treatment to alleviate symptoms. Data on pain in these patients are still scarce but can help improve symptom management. This study therefore aimed to describe patient-reported pain and quality of life.

Methods: 147 palliatively treated stage IV colorectal cancer patients diagnosed between 2018 and 2023 completed the EORTC QLQ-C30 and QLQ-CR29 before and 12 months after treatment initiation within the EDIUM study. Descriptive results for pain and quality of life were examined and compared to reference values. A logistic regression analysis investigated the relationship between quality of life and pain and 1-year survival.

Results: The mean (SD) for the "overall pain" score was 26 (32) (T0) and 35 (32) (T1) for rectal cancer patients and 34 (33) (T0) and 35 (32) (T1) for colon cancer patients. This is higher than the reference value (24 (30)) and indicates high average pain levels. The "overall quality of life" score showed means below the reference value (61 (23)), indicating poorer quality of life (colon: 51 (25) (T0), 56 (22) (T1); rectum: 52 (24) (T0), 51 (22) (T1)). Higher pain levels persisted at both time points, with no patients reporting absence of pain. The logistic regression results suggest a small relationship between pain and quality of life and 1-year survival.

Discussion: This study reveals high levels of pain among palliatively treated colorectal cancer patients, impacting their quality of life. Effective pain management and close monitoring are necessary to improve the quality of life for these patients.

Trail number: DRKS00008724.

Keywords: Colorectal neoplasms; Pain; Palliative care; Patient reported outcomes; Quality of life.

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Conflict of interest statement

Declarations. Ethical approval: The study was advised and approved by the ethics committee of the Berlin Medical Association (Eth-19/18). All the patients gave written consent for their participation in the study. Competing interests: CK, NTS, CB, SKS are employees of the German Cancer Society (DKG). SB and TS are members of the Scientific Advisory Board of the DKG. TS is a Board Member of the DKG. VK is employee of ClarData and OnkoZert, the certifying body of the German Cancer Society. JB has received payments for a lecture by Coloplast; has received support for travel and accommodations from Intuitive Surgical and is part of the EsmAil Trial Advisory Board. JO has received a study grant from the Federal Joint Committee in Germany. DW received payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events for the German Society for General and Visceral Surgery and Medtronic. PAN received grants or contracts from the German Cancer Association, for the German Research Foundation Project, the Albrecht Stuppler Clinician Scientist Fellowship, the Bavarian Research Foundation and B. Braun Foundation; received payments for lectures from Johnson&Johnson and Dr. Falk; received a travel grant for a congress from Johnson& Johnson (payment was made to the institution); was part of the Advisory Board Johnson&Johnson. All other authors have declared no conflicts of interest.

Figures

Fig. 1
Fig. 1
Consolidated Standards of Reporting Trials (CONSORT) chart for the EDIUM study sample
Fig. 2
Fig. 2
Sankey diagram for pain items from the EORTC QLQ-CR29 and C30 in colorectal cancer patients at T0 and T1. a, Pain (n = 120); b, interference with daily activities (n = 112); c, abdominal pain (n = 135); d, buttock pain (n = 129); e, dysuria (n = 144). The Sankey diagrams only include colorectal cancer patients who responded to the item at T0 and T1
See this image and copyright information in PMC

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