Oral Presentation COSA-IPOS Joint Scientific Meeting 2012

Who is at risk of poor quality of life after surgery for colorectal cancer? A prospective study (#30)

Ivana Durcinoska 1 , Jane Young 1 2 , Phyllis Butow 1 3 , Michael Solomon 1 4
  1. Surgical Outcomes Research Centre (SOuRCe), School of Public Health, University of Sydney & Sydney Local Health District, Camperdown, NSW, Australia
  2. Cancer Epidemiology and Services Research (CESR), School of Public Health, Univeristy of Sydney, Camperdown, NSW, Australia
  3. Centre for Medical Psychology and Evidence-based Decision Making (CeMPED), University of Sydney, Camperdown, NSW, Australia
  4. Discipline of Surgery, University of Sydney, Camperdown, NSW, Australia

Background: Following surgical resection of colorectal cancer, physical, emotional and functional recovery varies between patients. This study investigated factors predictive of decreased QoL in the first 6 months following surgery for colorectal cancer.

Methods: The ’usual care’ control group in the ‘CONNECT’ multi-centre randomized trial comprised the study sample for this analysis. Demographic, clinical and QoL data were collected at baseline (pre-surgery) and 1, 3 and 6 months post-surgery. For each participant, total and domain scores for the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) QoL instrument were compared between baseline and each follow up time point. Logistic regression models were used to identify significant, independent predictors of decreased QoL.

Results: Among 112 participants (61% male, 64% <70 years, 35% rectal cancer, 34% Dukes C/D), the proportion with decreased QoL at 1, 3, and 6 months was 62%, 46% and 37% respectively. Predictors of decreased QoL at 1 month were being male (Adjusted OR 2.74, 95% confidence interval 1.20-6.28) and having rectal cancer (4.01, 1.54-10.45). At 3 months, being male again was predictive (3.74, 1.59-8.81) as was being younger (3.48, 1.45-8.37) but site of cancer was not significant. By 6 months, only advanced stage of disease (Dukes C or D) at diagnosis (2.8, 1.24-6.32) was predictive.

Conclusions: In the first month following surgery, men and those with rectal cancer appear most at risk of poor QOL whereas by 6 months, it is those with advanced disease at diagnosis. These findings provide a focus for future interventions or services to improve patient outcomes.