Early results of quality of life for curatively treated rectal cancers in Chinese patients with EORTC QLQ-CR29

Department of Colorectal Surgery, Cancer Hospital Fudan University, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
Radiation Oncology (Impact Factor: 2.36). 08/2011; 6:93. DOI: 10.1186/1748-717X-6-93
Source: PubMed

ABSTRACT To assess the quality of life in curatively treated patients with rectal cancer in a prospectively collected cohort.
Patients with stage I-III rectal cancer who were treated curatively in a single institution were accrued prospectively. Quality of life was assessed by use of the European Organization for Research and Treatment of Cancer questionnaire module for all cancer patients (QLQ-C30) and for colorectal cancer patients (QLQ-CR29). Quality of life among different treatment modalities and between stoma and nonstoma patients was evaluated in all patients.
A total of 154 patients were assessed. The median time of completion for the questionnaires was 10 months after all the treatments. For patients with different treatment modalities, faecal incontinence and diarrhea were significantly higher in radiation group (p = 0.002 and p = 0.001, respectively), and no difference in male or female sexual function was found between radiation group and non-radiation group. For stoma and nonstoma patients, the QLQ-CR29 module found the symptoms of Defaecation and Embarrassment with Bowel Movement were more prominent in stoma patients, while no difference was detected in scales QLQ-C30 module.
Our study provided additional information in evaluating QoL of Chinese rectal cancer patients with currently widely used QoL questionnaires. As a supplement to the QLQ-C30, EORTC QLQ-CR29 is a useful questionnaire in evaluating curatively treated patients with rectal cancer. Bowel dysfunction (diarrhea and faecal incontinence) was still the major problem compromising QoL in patients with either pre- or postoperative chemoradiotherapy.

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    ABSTRACT: BackgroundWe aimed to investigate the impact of sociodemographic and clinical characteristics on health-related quality of life (HRQoL) in disease-free survivors after radical surgery for rectal cancer in a Chinese mainland population.MethodsWe performed a cross-sectional survey from August 2002 to February 2011 by use of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-CR38 questionnaires of 438 patients who underwent curative surgery for rectal cancer. Patients who were followed up for a minimum of 6 months, had no relevant major comorbidities and whose disease had not recurred were asked to complete both questionnaires. The impact of sociodemographic and clinical characteristics on HRQoL were compared by univariate and multivariate regression analyses.ResultsIn total, 285 patients responded to the survey (response rate, 65.1%). Psychological-related HRQoL variables such as emotional function (P = 0.021) and future perspectives (P = 0.044) were poorer for younger patients than for older patients; and physiological-related HRQoL was reflected by physical function (P = 0.039), which was poorer for older patients than for younger patients. In terms of physiologic function and symptoms concerning HRQoL, such as pain (P = 0.002) and insomnia (P = 0.018), females had lower values than males. Low education and unemployment were associated with a worse HRQoL. HRQoL was worse for patients with stomas compared to those without, especially in psychosocial areas such as role function (P = 0.025), social function (P <0.001) and body image (P = 0.004). Financial HRQoL was worse for younger patients and patients with stoma.ConclusionsHRQoL aspects and degrees to which they were impaired after curative surgery for rectal cancer were different when compared by many sociodemographic and clinical factors in Chinese mainland patients.
    World Journal of Surgical Oncology 05/2014; 12(1):161. DOI:10.1186/1477-7819-12-161 · 1.20 Impact Factor
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    ABSTRACT: Background Quality of life (QOL) concerns in patients with stomas is a globally important health issue. Currently, a lack of understanding into which factors influence QOL post-colostomy hinders the ability of health care professionals to provide appropriate instruction and care needed to improve a patient's QOL. Objectives To determine the level of stoma-specific QOL and to determine which factors associate with stoma-specific QOL among patients with a stoma. Methods A convenience sample of 76 patients with stomas was recruited from patients who presented to the ward for checkup in a tertiary hospital in Beijing. Quality of life, self-care, and hope were assessed in patients by the Stoma-QOL, stoma self-care agency scale, and Herth Hope Index, respectively. Statistical analyses were performed using Pearson correlation, t-test, and multiple linear regression analysis. Results Our stoma-QOL survey demonstrated that stoma patients experienced difficulties functioning in work and social situations, had issues with sexuality and body image, and difficulties with stoma function. Patients expressed concerns related to the stoma itself such as finding privacy to empty the pouch, problems with leakage, and difficulties participating in social activities. Multiple linear regression analysis indicated that self-care agency and hope were the main influencing factors and explained 23.4% of the variance of stoma function and 17.8% of the variance of work/social function. Conclusion QOL in patients with a stoma was not ideal. Our findings demonstrate that following stoma implantation, improvements in self-care and inspiring hope in patients played an important role in bettering their stoma-QOL. The strength of our study is that we adopted a stoma-specific questionnaire instead of a general scale such as EORTC C30.
    06/2014; DOI:10.1016/j.ijnss.2014.05.007
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    ABSTRACT: Background and Objectives: This review focuses on health-related quality-of-life (HRQoL) assessment questionnaires and the influence of various parameters on HRQoL at distinct time points after laparoscopic colectomy for cancer. Methods: A PubMed electronic database literature search was conducted. Results: Twenty studies (7 prospective randomized, 5 nonrandomized, 2 retrospective, 1 matched, and 3 observational studies) used the following HRQoL tools: European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)–C30 (8 studies), EORTC QLQ-CR38 (6 studies), EORTC QLQ-CR29 (1 study), Short Form 36 (8 studies), Gastrointestinal Quality Life Index (2 studies), EuroQoL-5D (1 study), Symptoms Distress Scale (2 studies), Quality of Life Index (2 studies), and global quality of life (1 study). Long-term beneficial effects on patient HRQoL after laparoscopic colectomy for cancer have not been clearly shown compared with “open” resections. A physical function deterioration and emotional function improvement are observed during the first month. Most patients have recovered at 12 months. Distinct HRQoL domains may be affected in older, female, and chemotherapy-treated patients. HRQoL-related parameters of pain and cosmesis have been assessed in few of the current studies on hand-assisted and single-incision laparoscopic colectomy. Conclusion: Studies' heterogeneity in terms of assessment tools and time points remains as the main obstacle to establish robust conclusions. The addition of more patients and extension of the follow-up period will improve our knowledge on HRQoL changes after laparoscopic colectomy for cancer.
    JSLS: Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons 03/2014; 18(2):225-235. DOI:10.4293/108680813X13753907291152 · 0.79 Impact Factor

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