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: 2.55). 08/2011; 6(1):93. DOI: 10.1186/1748-717X-6-93
Source: PubMed


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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    • "Using these questionnaires on stoma patients resulted in inconsistent reporting of QOL over time, suggesting that more specific and sensitive instruments are needed in order to gain further insight into the issues of most concern to stoma patients [5e7]. Previous studies have shown the level of QOL among CRC patients was not ideal and the presence of a stoma was found to be an independent factor in worsening QOL [8] [9]. Patients with a stoma have to cope with stoma-related technical problems as well as complications that develop as a result of the stoma. "
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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.
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    • "People in the East place more importance on family than those in the West. Moreover, compared with other studies concerning marital status, we found that the marriage rate of Chinese (more than 95%) was obviously higher than people of European descent (less than 80%) [10,30]. Following radical surgery for rectal cancer, Chinese patients may benefit in HRQoL from a contented married life and high marriage rate. "
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    ABSTRACT: Background We 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. Methods We 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. Results In 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. Conclusions HRQoL 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.
    Full-text · Article · May 2014 · World Journal of Surgical Oncology
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    ABSTRACT: We have systematically reviewed studies published in the last three years on patients’ self-reported evaluations of quality of life (QoL) and functions after chemoradiotherapy (CRT) for rectal cancer. Overall, the findings from 13 studies confirmed that CRT negatively affect functions and, consequently, patients’ QoL, especially for bowel, role, and social function. The studies’ heterogeneity limited the possibility of comparison among findings. We discuss and comment on the ideal characteristics of studies assessing QoL and function. We emphasise how this type of evidence is relevant to decision-making at all levels of health-care practice.
    No preview · Article · Jun 2013 · Current Colorectal Cancer Reports
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