Baseline Quality of Life of Physical Function Is Highly Relevant for Overall Survival in Advanced Rectal Cancer.

Tim Fitz,Luitpold V Distel,Rainer Fietkau,Sandra Rutzner,Christopher Sörgel,Markus Hecht

doi:10.3390/healthcare10010141

Abstract

In advanced rectal cancer, neoadjuvant radiochemotherapy and total mesorectal excision lead to long overall survival. The quality of life (QOL) of the patients is clearly related to the prognosis. Our question was whether the prognosis can be represented with only one question or one score from the QOL questionnaires. 360 consecutively recruited patients diagnosed with advanced rectal cancer were questioned during radiochemotherapy and a follow-up of 8 years. The questionnaires QLQ-C30 and QLQ-CR38 were used; 10 functional and 17 symptom scores were calculated. The functional score “physical function” and the symptom scores “fatigue”, “nausea and vomiting”, “pain” and “appetite loss” were highly prognostic (p < 0.001) for overall survival. “Physical function” was highly prognostic at all time points up to 1 year after starting therapy (p ≤ 0.001). The baseline “physical function” score divided the cohort into a favorable group with an 8-year overall survival rate of 70.4% versus an unfavorable group with 47.5%. In the multivariable analysis, baseline “physical function”, age and distant metastases were independent predictors of overall survival. The score “physical function” is a powerful unrelated risk factor for overall survival in patients with rectal cancer. Future analyses should study whether increased “physical function” after diagnosis could improve survival.

Highlights

In recent years and decades, quality of life (QOL) has taken on an increasingly important role in the treatment of patients
There is still no gold standard for a comprehensive assessment of QOL. This is because not all contributing parameters can always be determined and, on the other hand, the evaluation of QOL depends on the subjective assessment of the individual and cannot be measured externally
From May 2010 until June 2020, 360 consecutive rectal cancer (RC) patients who agreed to participate were included in a prospective longitudinal study

Summary

Introduction

In recent years and decades, QOL has taken on an increasingly important role in the treatment of patients. The field of QOL goes far beyond palliative care and is increasingly taken into account in the evaluation of therapy results or in diagnostics. There is still no gold standard for a comprehensive assessment of QOL. This is because not all contributing parameters can always be determined and, on the other hand, the evaluation of QOL depends on the subjective assessment of the individual and cannot be measured externally. For this reason, various questionnaires have been established that categorize QOL in order to visualize it and allow comparisons. Due to the good clinical manageability, we decided to use this method

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Discussion

Conclusion