Health-related quality-of-life trajectories during/after surgery and adjuvant chemotherapy in patients with colon cancer

Key summary points Aim To evaluate the health-related quality of life (HR-QoL) trajectory during the first year after cancer treatment in patients with resectable primary colon cancer. Findings On average, HR-QoL recovered to baseline level one year after start of treatment. However, 1 out of 7 pati...

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Published in:European geriatric medicine 2023-06, Vol.14 (3), p.565-572
Main Authors: Scheepers, E. R. M., Vink, G. R., Schiphorst, A. H. W., Emmelot-Vonk, M. H., van Huis-Tanja, L. H., Hamakerl, M. E.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Chemotherapy, Adjuvant - adverse effects
Cohort Studies
Colonic Neoplasms - etiology
Female
Geriatrics/Gerontology
Humans
Internal Medicine
Male
Medicine
Medicine & Public Health
Prospective Studies
Quality of Life
Research Paper
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Summary:Key summary points Aim To evaluate the health-related quality of life (HR-QoL) trajectory during the first year after cancer treatment in patients with resectable primary colon cancer. Findings On average, HR-QoL recovered to baseline level one year after start of treatment. However, 1 out of 7 patients, particularly older patients who received adjuvant chemotherapy, were at risk of non-resilience or a late decline in HR-QoL. Message Our findings provide insight in risks for a permanent loss of HR-QoL which may support patients and physicians in the treatment decision-making process to optimize tailored cancer care. Purpose This study aims to evaluate quality of life trajectory during the first year after surgical treatment in patients with resectable primary colon cancer. Methods Patients with resectable primary colon cancer diagnosed between 2013 and 2019 who received surgical treatment and adjuvant chemotherapy if indicated were selected from the Prospective Dutch ColoRectal Cancer cohort study (PLCRC). Health-related quality of life (HR-QoL) was assessed using EORTC-QLQ-C30 questionnaire before surgery, and three and twelve months after surgery. HR-QoL scores varied between 0 and 100 and outcomes were compared according to age (< 70 years, ≥ 70 years), comorbidity (yes, no) and treatment type (adjuvant chemotherapy, surgical treatment only). The extent of resilience, defined as a recovery of HR-QoL to baseline level after a clinically relevant decline in HR-QoL at months, was calculated twelve months post-surgery. Results For all 458 patients, the mean age was 66.4 years (SD 9.5), 40% were aged 70 years and older and 68% were men. Baseline level of HR-QoL summary score was relatively high with a mean of 87.9 (SD 11.5), and did not significantly differ between older and younger patients. The strongest decline of HR-QoL compared to baseline was observed at three months with a gradual recovery over time. Fourteen percent of all patients were non-resilient or showed a late decline at twelve months post-surgery. Compared to younger patients, older patients who received adjuvant chemotherapy were less resilient (respectively, 53 and 32%, p  = 0.07) and at risk of a late decline in HR-QoL 1 year post-surgery (respectively, 3% versus 16%, p  = 0.02). Comorbidity status had no significant impact on the HR-QoL trajectory. Conclusion Colon cancer treatment was associated with a decline in HR-QoL three months post-surgery, but most patients return to baseline leve
ISSN:1878-7649
1878-7657
1878-7657
DOI:10.1007/s41999-023-00750-9