Health-related quality-of-life assessment in gastrointestinal cancer: are results relevant for clinical practice?
OBJECTIVE
Health-related quality-of-life studies are now recognized as critical to understand the burden of disease and treatments on patients' well being. Significant advances have been recently achieved in gastrointestinal cancers, including the development and clinical use of new robust quality-of-life instruments. We review recent literature to evaluate whether quality-of-life assessment contributes to optimal patient information and helps treatment choices.


RESULTS
Treatments of gastrointestinal cancers have changed in the last few years with increasing use of multimodal therapies and advances in surgical techniques, especially for low-lying rectal cancers. Concurrent to the development of sphincter-saving procedures, however, the long-term consequences of a permanent stoma on quality of life have been debated. Results of new palliative treatments should also be considered looking at preservation or improvement of quality of life and not only prolongation of life.


CONCLUSIONS
Gastrointestinal malignancies impact strongly on patient quality of life due to the aggressiveness of the treatments. Short-term negative effects of surgery and specific deficits in survivors were recently described in gastrointestinal cancers. Baseline quality-of-life data predict length of survival in hepatocarcinoma and metastatic colorectal cancer. Generally, quality-of-life results help to fully inform the patients of the advantages or disadvantages of therapeutic options, including adjuvant and palliative treatments.
Conroy
Thierry
T
Department of Medical Oncology, Alexis Vautrin Centre and EA 4003, Nancy-University, Vandoeuvre-lès-Nancy, France. t.conroy@nancy.fnclcc.fr
Uwer
Lionel
L
Deblock
Mathilde
M
D003657:Decision Making; D005743:Gastrectomy; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy / Q000523:psychology / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D010166:Palliative Care; D011788:Quality of Life; D018434:Sickness Impact Profile