Health-related quality-of-life trajectories during/after surgery and adjuvant chemotherapy in patients with colon cancer.

Abstract

This study aims to evaluate qualityoflife trajectory during the first year after surgical treatment in patients with resectable primary colon cancer. Patients with resectable primary colon cancer diagnosed between 2013 and 2019 who received surgical treatment and adjuvant chemotherapy if indicated were selected from the Prospective Dutch ColoRectal Cancer cohort study (PLCRC). Health-related quality of life (HR-QoL) was assessed using EORTC-QLQ-C30 questionnaire before surgery, and three and twelvemonths after surgery. HR-QoL scores varied between 0 and 100 and outcomes were compared according to age (< 70years, ≥ 70years), comorbidity (yes, no) and treatment type (adjuvant chemotherapy, surgical treatment only). The extent of resilience, defined as a recovery of HR-QoL to baseline level after a clinically relevant decline in HR-QoL atmonths, was calculated twelvemonths post-surgery. For all 458 patients, the mean age was 66.4years (SD 9.5), 40% were aged 70years and older and 68% were men. Baseline level of HR-QoL summary score was relatively high with a mean of 87.9 (SD 11.5), and did not significantly differ between older and younger patients. The strongest decline of HR-QoL compared to baseline was observed at threemonths with a gradual recovery over time. Fourteen percent of all patients were non-resilient or showed a late decline at twelvemonths post-surgery. Compared to younger patients, older patients who received adjuvant chemotherapy were less resilient (respectively, 53 and 32%, p = 0.07) and at risk of a late decline in HR-QoL 1year post-surgery (respectively, 3% versus 16%, p = 0.02). Comorbidity status had no significant impact on the HR-QoL trajectory. Colon cancer treatment was associated with a decline in HR-QoL threemonths post-surgery, but most patients return to baseline level within twelvemonths. Still, particularly older patients who received adjuvant chemotherapy were less resilient and at risk of a late decline in HR-QoL. These data could help in patients counselling regarding colon cancer treatment.