Abstract
BackgroundLaparoscopic colectomy (LC) is a less invasive alternative to open colectomy (OC) in the treatment of stage I–III colon cancer. Research on the long-term (5-year post-diagnosis) health-related quality of life (HRQOL) of LC patients is scarce. Our study aimed to compare the long-term HRQOL and psychological well-being of stage I–III colon cancer survivors treated either with LC or OC.MethodsThis study used a German population-based cohort of patients treated with either LC (n = 86) or OC (n = 980). LC patients were matched to OC patients using a propensity score. At 5-year follow-up, patients completed assessments on HRQOL (EORTC QLQ-C30 and EORTC QLQ-CR29) and psychological well-being (distress and disease/treatment burden). Least square mean scores of HRQOL were derived using linear regression. Proportions of patients with moderate/high distress and disease/treatment burden were compared with Chi-square tests.ResultsIn total, 81 LC patients were matched to 156 OC patients. Generally, LC patients had HRQOL comparable to OC patients, albeit LC patients reported significantly better body image (87.1 versus 81.0, p = 0.03). Distress levels were generally low and comparable between the two groups, even though LC patients were more likely to experience disease recurrence (16% versus 7%, p = 0.02) than OC patients. OC patients were more likely to feel moderate/high levels of burden associated with the treatment (72% versus 56%, p = 0.01) and the time after treatment completion (43% versus 28%, p = 0.02).ConclusionLC patients reported comparable long-term HRQOL outcomes but higher levels of psychological well-being than OC patients 5 years after diagnosis, even though LC was associated with higher risk of disease recurrence.
Highlights
Laparoscopic colectomy (LC) is a less invasive alternative to open colectomy (OC) in the treatment of stage I–III colon cancer
Patients treated with LC were significantly younger at diagnosis than those treated with OC (65.0 ± 10.5 versus 67.8 ± 9.8, p = 0.01) (Table 1)
LC patients were more likely to have stage I disease, have a tumor located in the distal colon, treated in a large volume hospital, less likely to have hypertension, were better educated, employed, living in the city, and weight within normal Body mass index (BMI) range when compared with OC patients
Summary
Laparoscopic colectomy (LC) is a less invasive alternative to open colectomy (OC) in the treatment of stage I–III colon cancer. Our study aimed to compare the long-term HRQOL and psychological well-being of stage I–III colon cancer survivors treated either with LC or OC. At 5-year follow-up, patients completed assessments on HRQOL (EORTC QLQ-C30 and EORTC QLQ-CR29) and psychological well-being (distress and disease/treatment burden). Proportions of patients with moderate/ high distress and disease/treatment burden were compared with Chi-square tests. Distress levels were generally low and comparable between the two groups, even though LC patients were more likely to experience disease recurrence (16% versus 7%, p = 0.02) than OC patients. Conclusion LC patients reported comparable long-term HRQOL outcomes but higher levels of psychological well-being than OC patients 5 years after diagnosis, even though LC was associated with higher risk of disease recurrence
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