Quality-of-life and surgical treatments for rectal cancer--a longitudinal analysis using the California Cancer Registry.
BACKGROUND
Heterogeneous results for research investigating health-related quality of life (HRQL) in patients undergoing sphincter-ablating procedures for rectal cancer are likely due to single institution experiences and measurement of HRQL. To address this heterogeneity, we evaluated HRQL in patients with rectal cancer by type of surgery, location of tumor, and receipt of adjuvant therapy using an HRQL instrument that has not been used to address rectal cancer patients in a population-based sample over time.


METHODS
The Functional Assessment of Cancer Therapy-Colorectal instrument was administered at 9 and 19 months after diagnosis to a consecutive sample of 160 patients in Northern California identified by the California Cancer Registry. A broad multidimensional interpretation of HRQL was used to examine the impact of tumor location and treatment status, stage of disease, age, and gender.


RESULTS
In general, men had lower social well-being scores, and younger patients had lower physical and emotional well-being scores and colorectal concerns scores. We found no differences in HRQL by either tumor location or type of surgery, at either 9 or 19 months after diagnosis. Lower physical well-being and greater adverse colorectal concerns were reported at 9 months among patients who received adjuvant therapy; however, only adverse colorectal concerns persisted over time.


CONCLUSIONS
This study provides additional evidence that sphincter-ablating procedures do not necessarily reduce quality of life in patients with rectal cancer. Distinctive features of this study include a broad multidimensional interpretation of HRQL, the 19 months of longitudinal follow-up, and a prospective population-based study design.
School of Community Health Sciences, University of Nevada, Reno, NV 89557-0208, USA. jsmithgagen@unr.edu
Julie
J
Smith-Gagen
Rosemary D
RD
Cress
Christiana M
CM
Drake
Patrick S
PS
Romano
Kathleen J
KJ
Yost
John Z
JZ
Ayanian
D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000601:surgery; D002140:California; D017024:Chemotherapy, Adjuvant / Q000523:psychology; D015179:Colorectal Neoplasms / Q000473:pathology / Q000523:psychology* / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011788:Quality of Life / Q000523:psychology*; D018714:Radiotherapy, Adjuvant / Q000523:psychology; D012042:Registries; D012737:Sex Factors