title: Long-term changes in physical capacity after colorectal cancer treatment.
abstract: Older patients with colorectal cancer are faced with the dilemma of choosing between the short-term risks of treatment and the long-term risks of insufficiently treated disease. In addition to treatment-related morbidity and mortality, patients may suffer from loss of physical capacity. The purpose of this review was to gather all available evidence regarding long-term changes in physical functioning and role functioning after colorectal cancer treatment, by performing a systematic Medline and Embase search. This search yielded 27 publications from 23 studies. In 16 studies addressing physical functioning after rectal cancer treatment, a median drop of 10% (range -26% to -5%) in the mean score for this item at three months. At six months, mean score was still 7% lower than baseline (range -18% to 0%) and at twelve months 5% lower (range -13% to +5%). For role functioning (i.e. ability to perform daily activities) after rectal cancer treatment, scores were -18% (range -39% to -2%), -8% (range -23% to +6%) and -5% (range -17% to +10%) respectively. Elderly patients experience the greatest and most persistent decline in self-care capacity (up to 61% at one year). This systematic review demonstrates that both physical functioning and role functioning are significantly affected by colorectal cancer surgery. Although initial losses are recovered partially during follow-up, there is a permanent loss in both aspects of physical capacity, in patients of all ages but especially in the elderly. This aspect should be included in patient counselling regarding surgery.
authors.affiliation: Diakonessenhuis Utrecht/Zeist/Doorn, Department of Geriatric Medicine, Professor Lorentzlaan 76, 3707 HL, Zeist, The Netherlands.
authors.forename: Marije E
authors.initials: ME
authors.lastname: Hamaker
authors.affiliation: Diakonessenhuis Utrecht/Zeist/Doorn, Department of Geriatric Medicine, Professor Lorentzlaan 76, 3707 HL, Zeist, The Netherlands.
authors.forename: Meike C
authors.initials: MC
authors.lastname: Prins
authors.affiliation: Department of Surgery, Diakonessenhuis Utrecht, The Netherlands.
authors.forename: Anandi H
authors.initials: AH
authors.lastname: Schiphorst
authors.affiliation: Department of Gastroenterology, Diakonessenhuis Utrecht, The Netherlands.
authors.forename: Sebastiaan A C
authors.initials: SA
authors.lastname: van Tuyl
authors.affiliation: Department of Surgery, Diakonessenhuis Utrecht, The Netherlands.
authors.forename: Apollo
authors.initials: A
authors.lastname: Pronk
authors.affiliation: Department of Internal Medicine, Haga Hospital, The Hague, The Netherlands.
authors.forename: Frederiek
authors.initials: F
authors.lastname: van den Bos
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000628:therapy*; D006801:Humans; D020127:Recovery of Function; D012004:Rectal Neoplasms / Q000628:therapy*; D017741:Survivors; D013995:Time
keywords: Colorectal surgery; Functional outcome; Physical capacity; Role functioning