Pucciarelli Salvatore, Del Bianco Paola, Toppan Paola, Serpentini Samantha, Efficace Fabio, Pasetto Lara Maria, Friso Maria Luisa, De Salvo Gian Luca, Nitti Donato
Department of Oncological and Surgical Sciences, Section of Clinica Chirurgica II, University of Padova, Policlinico, VI piano, Via Giustiniani, 2, 35128, Padova, Italy.
Ann Surg Oncol. 2008 Jul;15(7):1846-54. doi: 10.1245/s10434-008-9923-0. Epub 2008 May 6.
The main objective of this study was to investigate health-related quality of life (HRQOL) in terms of symptoms and functional outcomes in disease-free survivors of rectal cancer.
Consecutive patients (n = 117) who underwent curative surgery for rectal cancer with a minimum of 2 years' follow-up and whose disease had not recurred were asked to complete the European Organization for Research and Treatment of Cancer QLQ-C30 and its colorectal cancer module (QLQ-CR38). Long-term HRQOL outcomes were compared with reference data from the general population. Relevant clinical data including type of surgery, stage of disease, type of treatment, and early and late complications were collected. Univariate and multivariate regression analyses were performed to investigate associations among covariates.
HRQOL functional aspects were similar with that of an age- and sex-matched general population. Although clinically meaningful better outcomes favoring our patients were found for the global health status/HRQOL and the pain scales, constipation was worse in rectal cancer survivors than the general population. Multivariate analysis found that worse physical functioning was associated with increasing age (P < .001), female sex (P < .01), presence of stoma (P < .05), and occurrence of late major complications (P < .05). Worse body image was associated with the presence of stoma (P < .001) and chemoradiotherapy (P < .05).
Overall, patients with rectal cancer recover well in the long run, with HRQOL levels comparable to that of the general population. HRQOL outcomes provide valuable data that may be used to improve information disclosure to patients.
本研究的主要目的是从直肠癌无病生存者的症状和功能结局方面调查健康相关生活质量(HRQOL)。
连续纳入117例接受直肠癌根治性手术且至少随访2年且疾病未复发的患者,要求他们完成欧洲癌症研究与治疗组织的QLQ-C30及其结直肠癌模块(QLQ-CR38)。将长期HRQOL结局与一般人群的参考数据进行比较。收集包括手术类型、疾病分期、治疗类型以及早期和晚期并发症在内的相关临床数据。进行单因素和多因素回归分析以研究协变量之间的关联。
HRQOL功能方面与年龄和性别匹配的一般人群相似。尽管在全球健康状况/HRQOL和疼痛量表方面发现有利于我们患者的具有临床意义的更好结局,但直肠癌幸存者的便秘情况比一般人群更严重。多因素分析发现,较差的身体功能与年龄增加(P <.001)、女性(P <.01)、造口的存在(P <.05)以及晚期主要并发症的发生(P <.05)相关。较差的身体形象与造口的存在(P <.001)和放化疗(P <.05)相关。
总体而言,直肠癌患者从长远来看恢复良好,HRQOL水平与一般人群相当。HRQOL结局提供了有价值的数据,可用于改善向患者的信息披露。