Department of General Surgery, University Hospital of Larissa, Mezourlo, Larissa, Greece.
J BUON. 2021 Jul-Aug;26(4):1266-1270.
Never before the preoperative quality of life (QoL) score of colorectal cancer (CRC) patients was analyzed and linked directly to cancer staging according to pathology in specimens and, thereafter, in patients to estimate long-term prognosis. Our study attempted to give answers to these questions.
This was a prospective study of 80 elderly patients who underwent major colorectal surgery for cancer in a single University's surgical department conducted between 01/2018 and 12/2018. All patients aged >65 years, diagnosed with a resectable CRC without metastatic disease undergoing an elective surgery were prospectively included. As exclusion criteria were considered age <65 years, an emergency operation, non-resectable tumor, stage IV CRC and American Society of Anesthesiologists (ASA) score IV. All patients were asked to answer a self-administered questionnaire of the validated Greek version of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30.
Comparison of the mean score of EORTC QLQ-C30 showed stage I CRC was 87.62% (11.81%), 77.24% (12.91%) in stage II patients and 78.99% (15.25%) in stage III cancer. The mean difference between the three groups was statistically significant (p=0.002). Moreover, in post-hoc analysis, there was a statistically significant difference in the mean QLQ-C30 score between patients with stage I and stage II cancer (p=0.043) and between patients with stage I and stage III tumor (p=0.01), but this difference was not observed when comparing patients with stage II and III cancer (p=0.319).
Our study demonstrated a significant association between preoperative QoL and tumor staging as shown in the specimen's examination in elderly patients with CRC. More prospective studies are needed to elucidate how QoL and its fluctuations during the postoperative period can be correlated with long-term survival and disease progression in elderly CRC patients.
以前从未根据病理对结直肠癌（CRC）患者的术前生活质量（QoL）评分进行分析，并将其直接与癌症分期相关联，然后在患者中估计长期预后。我们的研究试图回答这些问题。
这是一项前瞻性研究，共纳入 80 名在 2018 年 1 月至 12 月期间在一家大学外科部门接受主要结直肠手术的老年 CRC 患者。所有年龄>65 岁、诊断为无转移疾病的可切除 CRC 且接受择期手术的患者均被前瞻性纳入。排除标准为年龄<65 岁、急诊手术、不可切除肿瘤、IV 期 CRC 和美国麻醉医师协会（ASA）评分 IV。所有患者均被要求回答一份由希腊版欧洲癌症研究与治疗组织（EORTC）QLQ-C30 验证的自我管理问卷。
EORTC QLQ-C30 平均评分的比较显示，I 期 CRC 为 87.62%（11.81%），II 期患者为 77.24%（12.91%），III 期癌症为 78.99%（15.25%）。三组之间的平均差异具有统计学意义（p=0.002）。此外，在事后分析中，I 期和 II 期癌症患者的 QLQ-C30 评分均值之间存在统计学显著差异（p=0.043），I 期和 III 期肿瘤患者之间也存在统计学显著差异（p=0.01），但 II 期和 III 期癌症患者之间的差异无统计学意义（p=0.319）。
我们的研究表明，在 CRC 老年患者中，术前 QoL 与肿瘤分期之间存在显著关联，这种关联在标本检查中得到了体现。需要更多的前瞻性研究来阐明 QoL 及其在术后期间的波动如何与老年 CRC 患者的长期生存和疾病进展相关。
