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Quality of life and symptoms in long-term survivors of colorectal cancer: results from NSABP protocol LTS-01

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Abstract

Purpose

Little is known about health-related quality of life (HRQL) in long-term survivors (LTS) of colorectal cancer (CRC).

Methods

Long-term CRC survivors (≥5 years) treated in previous National Surgical Adjuvant Breast and Bowel Project trials were recruited from 60 sites. After obtaining consent, a telephone survey was administered, which included HRQL instruments to measure physical health (Instrumental Activities of Daily Living [IADL], SF-12 Physical Component Scale [PCS], SF-36 Vitality Scale), mental health (SF-12 Mental Component Scale [MCS], Life Orientation Test, and Impact of Cancer), and clinical symptoms (Fatigue Symptom Inventory [FSI], European Organization for Research and Treatment of Cancer Colorectal Module [EORTC-CR38], and Brief Pain Inventory). A multivariable model identified predictors of overall quality of life (global health rating).

Results

Participants (N = 708) had significantly higher HRQL compared with age group-matched non-cancer controls with higher mean scores on SF-12 PCS (49.5 vs. 43.7, p = <0.05), MCS (55.6 vs. 52.1, p = <0.05), and SF-36 Vitality Scale (67.1 vs. 59.9, p = <0.05). Multivariable modeling has demonstrated that better overall physical and mental health (PCS and MCS), positive body image (EORTC-CR38 scale), and less fatigue (FSI), were strongly associated with overall quality of life as measured by the global health rating. Interestingly, ability to perform IADLs, experience of cancer, gastrointestinal complaints, and pain, were not important predictors.

Conclusions

In long-term CRC survivors, overall physical and mental health was excellent compared with general population. Other disease-related symptoms did not detract from good overall health.

Implications for cancer survivors

LTS of CRC within the setting of a clinical trial have higher HRQL than the general population, and treatment regimens do not appear to be associated with any significant late effects on quality of life.

Trial Registration: NSABP LTS-01: NCT00410579.

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Acknowledgments

The National Cancer Institute at the National Institutes of Health, US Department of Health and Human Services, Public Health Service grants U10-CA180868 (NCTN), U10-CA180822 (NRG SDMC), and UG1CA189867 (NCORP), and grant RSGPB-05-236-01-CPPB from the American Cancer Society (UCLA) are acknowledged.

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Authors and Affiliations

  1. National Surgical Adjuvant Breast and Bowel Project (NSABP)/NRG Oncology, Pittsburgh, PA, USA

    Hiroko Kunitake, Marcia M. Russell, D. Lawrence Wickerham, Clifford Y. Ko & Patricia A. Ganz

  2. Boston University School of Medicine, Boston, MA, USA

    Hiroko Kunitake

  3. David Geffen School of Medicine at UCLA, VA Greater Los Angeles Healthcare System, 11301 Wilshire Boulevard, Mail Code 10H2, Los Angeles, CA, 90073, USA

    Marcia M. Russell & Clifford Y. Ko

  4. Department of Health Policy and Management, The University of Pittsburgh, Pittsburgh, PA, USA

    Ping Zheng & Greg Yothers

  5. The University of Pittsburgh, Pittsburgh, PA, USA

    Greg Yothers

  6. National Cancer Institute, Bethesda, MD, USA

    Stephanie R. Land

  7. UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA

    Laura Petersen

  8. Kaiser Permanente Oncology Clinical Trials Northern California, Vallejo, CA, USA

    Louis Fehrenbacher

  9. Greenville Health System Cancer Institute, Greenville, SC, USA

    Jeffery K. Giguere

  10. Allegheny Health Network Cancer Institute, Pittsburgh, PA, USA

    D. Lawrence Wickerham

  11. UCLA Schools of Medicine and Public Health and Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, USA

    Patricia A. Ganz

  12. NRG Oncology, Pittsburgh, PA, USA

    Greg Yothers

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  1. Hiroko Kunitake
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Correspondence to Marcia M. Russell.

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Kunitake, H., Russell, M.M., Zheng, P. et al. Quality of life and symptoms in long-term survivors of colorectal cancer: results from NSABP protocol LTS-01. J Cancer Surviv 11, 111–118 (2017). https://doi.org/10.1007/s11764-016-0567-y

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  • DOI: https://doi.org/10.1007/s11764-016-0567-y

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