Department of Surgery, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.
Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands.
Colorectal Dis. 2023 Jul;25(7):1381-1391. doi: 10.1111/codi.16543. Epub 2023 Mar 31.
Colorectal anastomotic leakage (AL) is a serious complication. Studies on the impact of AL on health-related quality of life (HRQoL) are scarce. We aimed to investigate the association between AL and HRQoL in colorectal cancer patients up to 2 years after diagnosis, and to evaluate whether AL is associated with a clinically relevant decrease in HRQoL over time.
Patients diagnosed with Stage I-III colorectal cancer undergoing elective surgical resection with primary anastomosis between 2010 and 2017 were included. HRQoL was evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30, represented by the summary score, and analysed at diagnosis and at 6 months and 2 years post-diagnosis. Multivariable linear regression was performed to assess the association between AL and HRQoL, while multivariable logistic regression was used to investigate the association between AL and a clinically relevant HRQoL decrease (≥10 points) during follow-up compared to the time of diagnosis.
In total, 1197 patients were included of whom 63 (5%) developed AL. AL was not associated with HRQoL at 6 months post-diagnosis nor at 2 years post-diagnosis. However, having AL was associated with an increased risk of a clinically relevant decrease in HRQoL at 6 months post-diagnosis (OR 3.65, 95% CI 1.62-8.21) but not at 2 years after diagnosis (OR 1.91, 95% CI 0.62-5.93).
Although AL was not associated with HRQoL at 6 months or 2 years post-diagnosis, AL was a determinant of a clinically relevant decrease in HRQoL at 6 months after diagnosis. Future work should identify feasible and effective strategies to prevent declines in QoL in this patient population.
结直肠吻合口漏（AL）是一种严重的并发症。关于 AL 对健康相关生活质量（HRQoL）影响的研究很少。我们旨在调查诊断后 2 年内 AL 与结直肠癌患者 HRQoL 的关系，并评估 AL 是否与 HRQoL 随时间的临床相关下降有关。
纳入 2010 年至 2017 年间接受择期手术切除并伴有原发吻合的 I-III 期结直肠癌患者。使用欧洲癌症研究与治疗组织生活质量问卷 C30 评估 HRQoL，表现为总分，并在诊断时以及诊断后 6 个月和 2 年进行分析。采用多变量线性回归评估 AL 与 HRQoL 的关系，采用多变量逻辑回归评估 AL 与随访期间（与诊断时相比） HRQoL 临床相关下降（≥10 分）的关系。
共纳入 1197 例患者，其中 63 例（5%）发生 AL。AL 与诊断后 6 个月或 2 年时的 HRQoL 无关。然而，AL 与诊断后 6 个月时 HRQoL 临床相关下降的风险增加相关（OR 3.65，95%CI 1.62-8.21），但与诊断后 2 年时无关（OR 1.91，95%CI 0.62-5.93）。
尽管 AL 与诊断后 6 个月或 2 年时的 HRQoL 无关，但 AL 是诊断后 6 个月时 HRQoL 临床相关下降的决定因素。未来的工作应确定可行且有效的策略，以防止这一患者群体的生活质量下降。
