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.