Society of University SurgeonsSurgical complications exert a lasting effect on disease-specific health-related quality of life for patients with colorectal cancer*,**
Section snippets
Methods and patients
Patients with biopsy-proven colon or rectal cancer who were candidates for elective surgical resection were asked to participate in an institutional review board-approved prospective study. Seventy-five patients were enrolled over the period from August 1, 1999, to December 30, 2001. For the purpose of the measurement of HRQL, participating patients were asked to complete the Functional Assessment of Cancer Therapy survey for patients with Colorectal cancer (FACT-C) at the time of diagnosis and
Results
Seventy-five patients completed the FACT-C at the time of diagnosis, and at least 12 months had elapsed since the diagnosis of colorectal cancer. All patients had undergone open surgical therapy. Four of these patients, who underwent colostomy only, were excluded from the analysis. Of the remaining 71 patients, 63 completed the 12-month survey (88%); 4 patients (6%) died before the scheduled 12-month survey (cancer progression, 3; surgical complication, 1 [this patient experienced a fatal
Discussion
Although many therapeutic choices for patients with colorectal cancer are based on the predicted impact of therapy on quality of life and not oncologic concerns, little information exists to guide these decisions. Examples of such decisions include local excision of rectal cancer versus radical excision, sphincter preservation for distal rectal cancer versus abdominoperineal resection, and laparoscopic versus open surgical resection of colon cancer. In several cases, preliminary studies have
Conclusion
The present study represents an initial step toward an understanding of the association of perioperative patient-, tumor-, and treatment-related variables with HRQL 12 months after diagnosis for patients with colorectal cancer. Of the factors that were examined, initial score at diagnosis and the occurrence of perioperative complications exhibited the most significant association with eventual HRQL at 12 months. These data suggest that decreasing complications will result in improved HRQL
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2018, American Journal of SurgeryCitation Excerpt :A short-term impact of complications and readmission on quality of life and physical functioning after surgery is plausible and a six months follow-up might be relatively short for complete physical and mental recovery. Shortly after a negative treatment experience patients value their quality of life lower, and assessment of quality of life and functional status may change following complications and readmission.26,27 A previous quality of life study with 2 years of follow-up, however, showed only marginal improvements after 6 months.12
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Reprint requests: Thomas Anthony, MD, Chief, Surgical Services (112), VA North Texas Health Care Institute, 4500 South Lancaster Rd, Dallas, TX 75216.
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0039-6060/2003/$30.00 + 0