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

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A Correction to this article was published on 03 May 2023

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Key summary points

AbstractSection 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.

AbstractSection 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.

AbstractSection 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.

Abstract

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 level within twelve months. Still, particularly older patients who received adjuvant chemotherapy were less resilient and at risk of a late decline in HR-QoL. These data could help in patients counselling regarding colon cancer treatment.

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Data availability

Netherlands Comprehensive Cancer Organisation (IKNL) and Prospective Dutch ColoRectal Cancer cohort (PLCRC).

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Acknowledgements

The authors would like to thank the registration team of Netherlands Comprehensive Cancer Organisation (IKNL) and investigators of the Prospective Dutch ColoRectal Cancer cohort for the collection of data.

Funding

Dr. Vink reports grants from Servier, grants from BMS, grants from Merck, grants from Sirtex, grants from Bayer, grants from PGDx, from Pierre-Fabre, outside the submitted work; all other authors have nothing to disclose.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Diakonessenhuis Utrecht, Utrecht, The Netherlands

    E. R. M. Scheepers & L. H. van Huis-Tanja

  2. Department of Medical Oncology, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands

    G. R. Vink

  3. Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands

    G. R. Vink

  4. Department of Surgery, Diakonessenhuis Utrecht, Utrecht, The Netherlands

    A. H. W. Schiphorst

  5. Department of Geriatric Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands

    M. H. Emmelot-Vonk

  6. Department of Geriatric Medicine, Diakonessenhuis Utrecht, Utrecht, The Netherlands

    M. E. Hamakerl

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Contributions

ES: study design, data analysis, writing, and tables/figures. GV: writing and approval of final document. AS: writing and approval of final document. ME: writing and approval of final document. LH: writing and approval of final document. MH: study design, writing, and approval of final document.

Corresponding author

Correspondence to E. R. M. Scheepers.

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Conflicts of interest

The authors declared that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research commitee and with the 1964 Helsinki declaration and its amendments or comparable ethical standards.

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All patients provided informed consent.

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The original online version of this article was revised: plus the same explanatory text of the problem as in the erratum/correction article.

Supplementary Information

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Supplementary data Figure S1. Patient selection (PPTX 52 KB)

41999_2023_750_MOESM2_ESM.docx

Supplementary data Table S1. Clinically relevant differences of HR-QoL at twelve months compared to baseline level, stratified by age. (docx 16 KB)

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Scheepers, E.R.M., Vink, G.R., Schiphorst, A.H.W. et al. Health-related quality-of-life trajectories during/after surgery and adjuvant chemotherapy in patients with colon cancer. Eur Geriatr Med 14, 565–572 (2023). https://doi.org/10.1007/s41999-023-00750-9

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