Quality of life and independence in activities of daily living preoperatively and at follow-up in patients with colorectal cancer.

Abstract

The aim of this exploratory study was to describe quality of life (QL) domains and independence in activities of daily living (ADL) in patients (n = 86) undergoing surgery for colorectal cancer. The patients were consecutively included, and two validated instruments, EORTC's QLQ-C30 and the Katz'/Hulter Asberg Index of Independence in ADL, were used preoperatively and at follow-up after 5-8 months. The findings were related to tumour localization, tumour burden according to Dukes' classification and to preoperative radiotherapy treatment. The results showed a significant improvement in the patients' scores for emotional functioning, appetite and global QL and a significant increase in financial impact at follow-up. The patients with colon cancer (n = 39) also had significantly less pain and less constipation at follow-up compared with preoperatively than did patients with rectal cancer (n = 47). The patients with rectal cancer, having undergone preoperative radiotherapy treatment, had significantly lower confidence intervals for means (95%) on the physical functioning and role functioning scales at follow-up versus preoperatively. Total ADL independence decreased from 70% of the patients preoperatively to 57% at follow-up, and independence in instrumental ADL decreased from 72% to 64% of the patients. No patient was dependent in personal ADL preoperatively, while 3% were dependent at follow-up. A lower mean score of global QL was found preoperatively and at follow-up for patients who were dependent in ADL than for patients who were independent in ADL. The instruments were found useful for evaluating individual patients in clinical practice.