title: Patient-reported outcomes after hepatic resection of colorectal cancer metastases.
abstract: OBJECTIVE
  Hepatic resection of colorectal carcinoma (CRC) liver metastases is increasing, but evidence for the impact of surgery on patient-reported outcomes (PROs) is limited. This study aimed to describe comprehensively the impact of liver surgery for CRC hepatic metastases on PROs.
  
  
  METHODS
  Consecutive patients selected for hepatic resection completed the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30 and Quality of Life Questionnaire-Liver Metastases C21 before and 3, 6, and 12 months after surgery. For functional scales, mean scores with 95% CIs were calculated at each time point, with differences in scores of at least 10 points considered clinically significant. Responses to symptom scales and items were categorized as minimal or severe. Proportions and 95% CIs for each symptom category were calculated.
  
  
  RESULTS
  Hepatic surgery was planned in 241 patients but abandoned in nine because of unresectable disease. There were two postoperative deaths, 58 complications (25.2%), and 32 patients (14.9%) with disease recurrence. Questionnaire compliance was excellent (> 95% at all time points). After surgery, most functional aspects of health decreased, and the proportions of patients with severe symptoms increased; role function deteriorated significantly, and 30% of patients reported severe activity/vigor problems. Functional scales recovered by 6 months and were maintained at 1 year. Postoperative symptoms returned to baseline levels at 12 months, but 32.1% of patients reported severe problems with sexual dysfunction and 11.9% with abdominal pain.
  
  
  CONCLUSIONS
  These findings provide new evidence regarding outcomes of liver resection for CRC metastases. It is recommended that patients be reassured that surgery has a minimal and short-lived detrimental impact on health.
authors.affiliation: School of Social and Community Medicine, University of Bristol, and University Hospitals Bristol National Health Service Foundation Trust, Bristol, United Kingdom.
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Rees
authors.forename: Jane M
authors.initials: JM
authors.lastname: Blazeby
authors.forename: Peter
authors.initials: P
authors.lastname: Fayers
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Friend
authors.forename: Fenella K S
authors.initials: FK
authors.lastname: Welsh
authors.forename: Timothy G
authors.initials: TG
authors.lastname: John
authors.forename: Myrddin
authors.initials: M
authors.lastname: Rees
mesh_terms: D000368:Aged; D001707:Biopsy, Needle; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology; D011446:Prospective Studies; D011788:Quality of Life; D018570:Risk Assessment; D012647:Self-Assessment; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D016896:Treatment Outcome