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局部复发性直肠癌长期幸存者的生存问题:一项定性研究。

Survivorship issues in long-term survivors of locally recurrent rectal cancer: A qualitative study.

作者信息

McKigney Niamh, Waldenstedt Sophia, Gonzalez Elisabeth, van Rees Jan M, Thaysen Henriette Vind, Angenete Eva, Velikova Galina, Brown Julia M, Harji Deena P

机构信息

Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK.

Department of Surgery, SSORG-Scandinavian Surgical Outcomes Research Group, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

出版信息

Colorectal Dis. 2025 Mar;27(3):e70051. doi: 10.1111/codi.70051.

Abstract

AIM

There are increasing numbers of long-term survivors following curative treatment for locally recurrent rectal cancer (LRRC); however, their experiences remain relatively underreported. The aim of this qualitative study was to identify the long-term survivorship issues relevant to these patients.

METHOD

Adults who remained disease free >3 years following treatment for LRRC were invited to participate in an international multicentre study. Semistructured qualitative interviews were conducted either in person, via telephone or via Microsoft Teams and were analysed using a framework method of thematic analysis.

RESULTS

A total of 26 participants were recruited from 11 sites in seven countries. Sixteen (61.5%) participants were male, the median age was 70.5 (33.0-85.0) years, participants were a median of 5.0 (3.0-17.0) years posttreatment, most had undergone surgery for LRRC (n = 24, 92.3%), two participants received neoadjuvant chemo/radiation for LRRC with a complete response. Eight major survivorship themes were identified: (1) experience of long-term follow-up care, (2) unmet needs and areas for improvement, (3) long-term physical effects of cancer and treatment, (4) living with a stoma, urostomy or other urinary device, (5) long-term psychological impact, (6) impact on sexual function and intimate relationships, (7) impact on daily life and (8) feelings surrounding life now, adapting and the future.

CONCLUSION

Participants experienced a wide range of long-term survivorship issues, reflecting the complexity of both LRRC and its treatment. Despite this, most had adapted well. Further work regarding survivorship care in LRRC is required to address the unmet needs and issues highlighted in this study, such as support regarding sexual function.

摘要

目的

接受局部复发性直肠癌(LRRC)根治性治疗后的长期存活者数量日益增加;然而,他们的经历相对较少被报道。这项定性研究的目的是确定与这些患者相关的长期生存问题。

方法

邀请在LRRC治疗后无疾病存活超过3年的成年人参与一项国际多中心研究。通过面对面、电话或微软团队进行半结构化定性访谈,并使用主题分析的框架方法进行分析。

结果

共从7个国家的11个地点招募了26名参与者。16名(61.5%)参与者为男性,年龄中位数为70.5(33.0 - 85.0)岁,参与者治疗后中位数为5.0(3.0 - 17.0)年,大多数人接受了LRRC手术(n = 24,92.3%),两名参与者接受了LRRC新辅助化疗/放疗且完全缓解。确定了八个主要的生存主题:(1)长期随访护理的经历,(2)未满足的需求和改进领域,(3)癌症和治疗的长期身体影响,(4)带着造口、尿造口或其他泌尿装置生活,(5)长期心理影响,(6)对性功能和亲密关系的影响,(7)对日常生活的影响,以及(8)对当前生活、适应和未来的感受。

结论

参与者经历了广泛的长期生存问题,反映了LRRC及其治疗的复杂性。尽管如此,大多数人适应良好。需要进一步开展关于LRRC生存护理的工作,以解决本研究中突出的未满足需求和问题,如性功能方面的支持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e27a/11923726/7fdacc201e71/CODI-27-0-g001.jpg

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