Abstract
Patients with liver metastasis of colorectal cancer (CRC) experience important lifestyle changes that impair the quality of life (QoL). The use of instruments is important to assess the cancer patients’ QoL. To develop a Brazilian translation of the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Colorectal Liver Metastases (QLQ-LMC21) questionnaire, and to investigate psychometric validity in patients with CRC with liver metastases, patients with liver metastasis from CRC answered the Brazilian versions of EORTC core Quality of Life Questionnaire-Core 30 (QLQ-C30) and the QLQ-LMC21 module, a demographic data questionnaire and a questionnaire to assess understanding against the translated QLQ-LMC21. Data collection was performed in three Southern hospitals in Brazil, from August 2017 to August 2019. Descriptive analyses and Spearman’s correlation tests were performed for construct and criterion validity. The Cronbach’s alpha test was performed to assess reliability. Significant values were p < 0.05. Ten patients participated in the study for the pilot test and 106 for validation, with a mean age of 58.2 + 12.4 years old. The translated questionnaire was easy to understand for the participants in the pilot test phase, with no need for modification. In the validation of the convergent construct, all the correlations were significant (p < 0.001) and with coefficients above 0.53. In the discriminant validity, among items of different scales, the values of the divergent correlations were pain scale (0.005 to 0.186) and fatigue (−0.01 to 0.186), all non-significant. In the criterion validation, the correlations were significant, p < 0.05, and higher among similar scales of the QLQ-LMC21 and QLQ-C30, p-value < 0.001. The total internal consistency of the questionnaire was adequate, with a Cronbach’s alpha value of 0.790. The Brazilian version of the QLQ LMC21 proved to be a valid reliable questionnaire to be used in conjunction with the QLQ-C30.
Highlights
Colorectal cancer (CRC) is the third most frequent type of cancer worldwide, in both genders
Liver metastasis is the most frequent in approximately 19%–31% of the patients with CRC, of whom 25% present metastasis at the time of diagnosis, and 45%–50% develop it after 2 years of resection of the primary tumour [4, 5]
Our results demonstrated that the QLQ-LMC21 translated into Brazilian Portuguese was easy to understand by the patients, with good psychometric validity, with convergent and divergent construct validity, criterion validity and good internal consistency
Summary
Colorectal cancer (CRC) is the third most frequent type of cancer worldwide, in both genders. In 2018, the estimate was more than 1.8 million new cases and 861,663 deaths worldwide due to CRC [1]. For each year of 2020 and 2021, the estimate is 20,470 new cases in women and 20,520 in men. In 2017, the number of deaths was 9,207 in men and 9,660 in women in Brazil [2]. It is estimated that patients in stage IV, or metastatic CRC, has a 5-year survival rate of only 12% [3]. Liver metastasis is the most frequent in approximately 19%–31% of the patients with CRC, of whom 25% present metastasis at the time of diagnosis, and 45%–50% develop it after 2 years of resection of the primary tumour [4, 5]
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