Health-related quality of life in Slovenian patients with colorectal cancer: a single tertiary care center study

Assessment of Quality of Life in Patients with Colorectal Cancer in Kazakhstan

BACKGROUND

The problem of quality of life (QOL) of patients with colorectal cancer (CRC) is particularly relevant due to the dynamics of CRC incidence growth. This study aims to assess QOL of patients with CRC in the Republic of Kazakhstan in order to give an idea about the impact of burden on QOL of patients.

METHODS

A total of 319 patients diagnosed with CRC participated in this one-stage cross-sectional study. The survey was conducted between November 2021 and June 2022 at cancer centers in Kazakhstan.  Data were collected using the valid and reliable European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30, version 3.0).

RESULTS

The average age of respondents was 59, 23 (SD=10,604) years. The main age group 50-69 years old accounted for 62.1% of the total sample. Among all ill respondents, 153 (48%) were male and 166 (52%) were female. The mean global health status was 59.24 ± 22.62. Two of the five functional scales were below the ≥66.7% threshold, namely, emotional functioning 61.65 (28.04) and social functioning 61.96 (31.84); while scores for the other three were: physical functioning 69.38 (22.06), role functioning 69.69 (26.45), and cognitive functioning 74.60 (25.07).

CONCLUSIONS

This study gives an indication of good life functioning among our participants on the functional and symptom scales. However, they reported inadequate global health status.

Validity and Reliability of the Amharic Version of EORTC-QLQ-CR29 Among Colorectal Cancer Patients in Ethiopia

Background

The European Organization for Research and Treatment of Cancer - Quality of Life Questionnaire (EORTC-QLQ) developed to assess quality of life among colorectal cancer patients has not been translated into a local language or validated in the Ethiopian context. Therefore, this study aimed to examine the psychometric properties of the EORTC-QLQ-CR29 tool in Ethiopia among colorectal cancer patients.

Methods

A cross-sectional study was conducted in a major referral hospital in Addis Ababa, Ethiopia, from March to May, 2020. A total of 158 colorectal cancer patients were included. The validity of the tool was assessed using Multitrait Scale Analysis, Mann-Whitney test and Pearson correlation coefficient. The internal consistency was examined using Cronbach's alpha.

Results

Among the participants, 52.2% were men, with a median age of 46 years (IQR = 17.7 years). The item-total correlation alpha values ranged from 0.47 to 0.91. Multitrait Scale Analysis demonstrated convergent and divergent validity of the tool, except for the Blood and Mucus in Stool scale. All item correlations within their scales were greater than 0.4, except for the Blood and Mucus in Stool scale. The values of correlation coefficients between all items and their own domain were higher than other domains, except for the Blood and Mucus in Stool scale. The correlation between the core questionnaire and the colorectal tool ranged from -0.45 to 0.58. The tool showed a significant difference between stoma and non-stoma patients and between patients who had good physical function and those who did not.

Conclusion

The Amharic version of the EORTC-QLQ-CR29 tool can be used to assess the health-related quality of life in Ethiopian colorectal cancer patients.

Long-term quality of life, sexual health and gastrointestinal function following colorectal cancer resection in an Asian cohort

AIM

As populations age and cancer management improves, long-term survivorship and quality-of-life (QOL) outcomes are becoming equally important as oncological results. Data from Asian populations are scarce. We aimed to evaluate the sexual health, gastrointestinal function and QOL amongst colorectal cancer survivors in a tertiary referral centre in Singapore.

METHOD

Adults who had undergone elective curative surgery for non-metastatic colorectal cancer at least 2 years prior were included. Exclusion criteria were cognitive disease, serious postoperative complications or recurrent cancer. Participants were invited to complete the European Organization for Research and Treatment of Cancer Quality of Life Questionnaires EORTC-QLQ-C30 and QLQ-CR29. Using multiple bivariate analysis, r scores were used to examine relationship trends between QOL domains and survivor sociodemographic and disease-specific characteristics.

RESULTS

From February 2017 to July 2019, 400 responses were recorded. Median age and follow-up duration were 64 years (range 32-90) and 78 months (interquartile range 49-113) respectively. Patients who had Stage III cancer had better overall QOL scores compared to Stage I/II. Rectal (vs. colon) cancer negatively influenced sexual health and gastrointestinal function, but did not appear to affect overall QOL. Amongst our cohort, 57% (n = 129) of men and 43% (n = 75) of women were sexually active. Markers of socioeconomic status, including employment, education and housing type, were found to significantly impact perception of various aspects of QOL.

CONCLUSION

Knowledge of factors which influence well-being can identify individuals who may benefit from tailored management strategies. Regular patient-doctor contact may play a role in building and maintaining positive perspectives of cancer survivors. Normative data should be obtained from local populations to facilitate future comparative research.

Influence of concurrent capecitabine based chemoradiotherapy with bevacizumab on the survival rate, late toxicity and health-related quality of life in locally advanced rectal cancer: a prospective phase II CRAB trial

Background

Few studies reported early results on efficacy, toxicity of combined modality treatment for locally advanced rectal cancer (LARC) by adding bevacizumab to preoperative chemoradiotherapy, but long-term data on survival, and late complications are lacking. Further, none of the studies reported on the assessment of quality of life (QOL).

Patients and methods

After more than 5 years of follow-up, we updated the results of our previous phase II trial in 61 patients with LARC treated with neoadjuvant capecitabine, radiotherapy and bevacizumab (CRAB study) before surgery and adjuvant chemotherapy. Secondary endpoints of updated analysis were local control (LC), disease free (DFS) and overall survival (OS), late toxicity and longitudinal health related QOL (before starting the treatment and one year after the treatment) with questionnaire EORTC QLQ-C30 and EORTC QLQ-CR38.

Results

Median follow-up was 67 months. During the follow-up period, 16 patients (26.7%) died. The 5-year OS, DFS and LC rate were 72.2%, 70% and 92.4%. Patients with pathological positive nodes or pathological T3–4 tumors had significantly worse survival than patients with pathological negative nodes or T0–2 tumors. Nine patients (14.8%) developed grade ³3 late complications of combined modality treatment, first event 12 months and last 87 months after operation (median time 48 months). Based on EORTC QLQ-C30 scores one year after treatment there were no significant changes in global QOL and three symptoms (pain, insomnia and diarrhea), but physical and social functioning significantly decreased. Based on QLQ-CR38 scores body image scores significantly increase, problems with weight loss significantly decrease, but sexual dysfunction in men and chemotherapy side effects significantly increase.

Conclusions

Patients with LARC and high risk factors, such as positive pathological lymph nodes and high pathological T stage, deserve more aggressive treatment in the light of improving long-term survival results. Patients after multimodality treatment should be given greater attention to the regulation of individual aspects of quality of life and the occurrence of late side effects.

Validation of The Slovenian Version of the Low Anterior Resection Syndrome Score for Rectal Cancer Patients after Surgery

Purpose

The purpose of this study was to translate the low anterior resection syndrome (LARS) score into Slovenian and to test its validity on Slovenian patients who underwent low anterior rectal resection.

Methods

The LARS score was translated from English into Slovenian and then back-translated following international recommendations. The Slovenian version of the LARS questionnaire was completed by patients who underwent low anterior rectal resection between 1 January 2006 and 31 December 2010 at the University Medical Centre Ljubljana. An anchor question assessing the impact of bowel function on lifestyle was included. To assess test-retest reliability, some of the patients answered the LARS score questionnaire twice.

Results

A total of 100 patients (66.7%) of the 150 patients who were contacted for participation, were included in the final analysis. A total of 58 patients reported major LARS score. The LARS score was able to discriminate between patients who received radiotherapy and those who did not (p<0.001), and between total and partial mesorectal excision (p<0.001). Age was not associated with a greater LARS score (p=0.975). There was a perfect fit between the QoL category question and the LARS score in 66.0% of cases and a moderate fit was found in 24.0% of the cases, showing good convergent validity. Test-retest reliability of 51 patients showed a high intraclass correlation coefficient of 0.86.

Conclusions

The Slovenian translation of the LARS score is a valid tool for measuring LARS.