Liver transplantation (Ltx) in patients with nonresectable liver metastases from colorectal carcinoma.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 577-577 ◽  
Author(s):  
Svein Dueland ◽  
Morten Hagness ◽  
Pal-Dag Line ◽  
Tim Scholz ◽  
P. Jorgensen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Overall Survival ◽  
Liver Metastases ◽  
Physical Function ◽  
Primary Tumor ◽  
Palliative Chemotherapy ◽  
Life Questionnaire ◽  
Line Chemotherapy

577 Background: Liver resection is considered the only curative treatment of liver metastases (mets) from colo-rectal (CRC) tumors. Ltx is standard of care in selected patients with hepatocellular carcinoma, cholangiocarcinoma and neuroendocrine tumors. Patients with non-resectable liver metastases (mets) from colo-rectal cancer (CRC) receiving palliative chemotherapy have a median survival of about 2 and 1 year from start of 1. and 2. line chemotherapy, respectively. Overall 5 years survival in CRC patients after start of palliative chemotherapy is about 5-10%. In this study we examined overall survival after Ltx in selected CRC patients. The primary endpoint of the study was overall survival at 2 years after Ltx Methods: Major inclusion criteria were: non-resectable liver mets, no extra hepatic disease or local relapse determined by PET/CT scan, CT- or MRI scan and colonoscopy. No mets. on frozen section biopsies at time of surgery, ECOG 0-1, at least one line of chemotherapy for metastatic disease. Postoperative immunosuppresion: mTOR inhibitor (Rapamune), mycofpenolmofetil and tapering doses of prednisolon. Quality of life questionnaire (EORTC-C30) pre Ltx, 3, 6 and 12 months post Ltx. Results: Thirteen men and 8 women with non-resectable liver only CRC liver mets received Ltx in the period of Nov 2006 to March 2011. Median age was 56 years (range 45-65 years). Thirteen patients had colon cancer and 8 patients had rectal cancer. The T-stage of the primary tumor was T2,T3 and T4 in 2, 16 and 3 patients, respectively. N status of the primary tumor was: pN0, pN1 and pN2 all 7 patients. Nine patients had received 1.line chemotherapy and 12 patients had received 2. or 3.line therapy. The median number of liver mets was 8 (range 2-40) and the median size of the largest lesion was 4.5cm (range 2.8-13cm). The patients had good, stabile or increased Global Health Score and Physical Function at all time points after Ltx. Fifteen patients with follow-up of 2 years or more or death within 2 years of Ltx had 2 years overall survival of 87%. Conclusions: Long term survival is obtained after Ltx in selected patients with non-resectable liver mets from CRC. The patients reported good quality of life and physical function after Ltx.

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

Healthcare ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 141
Author(s):  
Tim Fitz ◽  
Christopher Sörgel ◽  
Sandra Rutzner ◽  
Markus Hecht ◽  
Rainer Fietkau ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Overall Survival ◽  
Physical Function ◽  
Multivariable Analysis ◽  
Advanced Rectal Cancer ◽  
Functional Score ◽  
Neoadjuvant Radiochemotherapy ◽  
Symptom Scores

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.

Quality of Life and Pain in Advanced Stage Prostate Cancer: Results of a Southwest Oncology Group Randomized Trial Comparing Docetaxel and Estramustine to Mitoxantrone and Prednisone

2006 ◽  
Vol 24 (18) ◽  
pp. 2828-2835 ◽  
Author(s):  
Donna L. Berry ◽  
Carol M. Moinpour ◽  
Caroline S. Jiang ◽  
Donna Pauler Ankerst ◽  
Daniel P. Petrylak ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Overall Survival ◽  
Sensitivity Analyses ◽  
Life Questionnaire ◽  
Random Assignment ◽  
Pain Palliation ◽  
Oncology Group ◽  
Southwest Oncology Group

Purpose Palliation of bone pain can be achieved in men with androgen-independent prostate cancer treated with docetaxel and estramustine (DE) or mitoxantrone and prednisone (MP). While Southwest Oncology Group trial 99-16 demonstrated a survival improvement of DE over MP, the study also was designed to compare the palliation of disease-related symptoms. Methods Pain palliation and global quality of life (QOL) were the two primary patient-reported outcomes. Pain was measured with the Present Pain Intensity scale of the McGill Pain Questionnaire-Short Form. The European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire C30 (QLQ-C30) and its Prostate Cancer Module (PR25) measured QOL and symptom status. Pain and analgesic use were measured at random assignment, every cycle for eight cycles, and 1 year from random assignment; the QLQ-C30 and the PR25 were administered at random assignment, before cycle four (week 10) and cycle eight (month 6) and at 1 year. In addition to the primary intent-to-treat, missing at random analysis, sensitivity analyses were performed to assess robustness of global QOL conclusions under alternative informative missing data assumptions. Results Six hundred seventy four eligible patients received DE (n = 338) or MP (n = 336). In an intention-to-treat analysis, median overall survival was 17.5 months for the DE arm and 15.6 months for the MP arm (P = .02). There were no statistically significant differences in pain palliation between the treatment arms. The sensitivity analyses showed a consistent lack of statistically significant global QOL differences for the two arms. Conclusion DE had superior clinical efficacy (overall survival, time-to-progression, and prostate-specific antigen declines) with similar global QOL and pain palliation in the MP arm.

scholarly journals QUALITY OF LIFE IN DEPRESSIVE PATIENTS FOLLOWED IN PSYCHOLOGY AND IN PSYCHIATRY

2017 ◽  
Vol 6 (1) ◽  
pp. 97
Author(s):  
Sandrine Martins Antunes ◽  
Lisete Dos Santos Mendes Monico
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Physical Function ◽  
Physical Performance ◽  
Depressive Symptomatology ◽  
Life Questionnaire ◽  
Role Emotional ◽  
Sf 36 ◽  
Depressive Patients

Abstract.This study aims to analyze and compare the Quality of Life in patients followed exclusively in Psychiatry and in patients followed exclusively in Psychology. Took part of the study 60 patients of both genders with depressive symptomatology and no other clinical diagnosis (exclusion criteria), 30 being exclusively followed at hospital psychiatric consultations and 30 exclusively followed in psychology consultations. After informed consent, we used the Quality of Life questionnaire (SF-36; Ware & Sherbourne, 1992), which showed good psychometric properties in its nine domains: Physical Function, Physical Performance, Body Pain, General Health, Vitality, Social Functioning, Role Emotional, Mental Health, and Health Change. We found that the patients followed in Psychology showed a better quality of life in Emotional and Physical Performance, as well as in Mental Health. Men expressed a similar quality of life to women, except in the field of Physical Function, higher in males. Single patients had better in Role Emotional and Mental Health, when compared to divorced and widowed. The results are discussed considering the benefits of psychological therapy in improving the quality of life of depressed patients.Keywords: Quality of life; Patients; Psychology; Psychiatry.Resumo.O presente estudo pretende analisar e comparar a Qualidade de Vida em pacientes exclusivamente acompanhados em consultas psiquiatria e em pacientes exclusivamente acompanhados em consultas de psicologia. Participaram no estudo 60 pacientes de ambos os sexos com sintomatologia depressiva e sem outro quadro clínico diagnosticado (critério de exclusão), sendo 30 exclusivamente acompanhados em consultas hospitalares de psiquiatria e 30 exclusivamente acompanhados em consultas de psicologia. Após consentimento informado, aplicámos o Questionário da Qualidade de Vida (SF-36; Ware & Sherbourne, 1992), que mostrou boas propriedades psicométricas nos nove domínios constituintes: Função física, Desempenho físico, Dor corporal, Saúde geral, Vitalidade, Função Social, Desempenho emocional, Saúde mental e Mudança de Saúde. Verificámos que os pacientes acompanhados em Psicologia mostraram uma melhor Qualidade de Vida ao nível dos domínios Desempenho emocional, Desempenho físico e Saúde mental. Os homens manifestaram uma Qualidade de Vida semelhante à das mulheres, excepto no domínio da Função física, superior no sexo masculino. Os pacientes solteiros apresentaram melhores Desempenho emocional e Saúde mental comparativamente aos divorciados e aos viúvos. Os resultados são discutidos numa abordagem dos benefícios da terapia psicológica na melhoria da qualidade de vida em doentes deprimidos.Palavras-chave: Qualidade de Vida; Pacientes; Psicologia; Psiquiatria

COUGAR-02: A randomized phase III study of docetaxel versus active symptom control in advanced esophagogastric adenocarcinoma.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. LBA4-LBA4 ◽  
Author(s):  
Hugo Ford ◽  
Andrea Marshall ◽  
Jonathan Wadsley ◽  
Fareeda Y. Coxon ◽  
Wasat Mansoor ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Overall Survival ◽  
Performance Status ◽  
Symptom Control ◽  
Locally Advanced ◽  
Phase Iii ◽  
First Line ◽  
Line Chemotherapy ◽  
Esophagogastric Adenocarcinoma

LBA4 Background: Survival in patients who relapse after first-line chemotherapy for advanced esophagogastric adenocarcinoma (OGC) is poor though recently randomized trials have suggested a small survival benefit for second-line chemotherapy with taxanes or irinotecan. There is very little data on quality of life or survival, particularly in patients who progress shortly after first-line therapy. Methods: COUGAR-02 was a multicenter open-label, randomized controlled phase III trial for patients with locally advanced or metastatic OGC of performance status (PS) 0-2 who had progressed within 6 months of previous platinum/fluoropyrimidine (PF) chemotherapy (CT). Patients were randomized (1:1) to receive either docetaxel 75mg/m2every 3 weeks for up to 6 cycles or active symptom control (ASC), which could include any treatment thought by the treating clinician to be appropriate for the management of symptoms including radiotherapy, steroids and supportive medications. The primary endpoint was overall survival. Secondary endpoints were response rate, toxicity, health related quality of life (HRQL) and healthcare resource use. Results: Between April 2008 and April 2012, 168 patients were recruited (84 patients in each arm). Median age was 65 years (range 28-84), 81% were male. PS at randomisation was 0 for 27%, 1 for 57% and 2 for 15%. Site of disease was stomach in 46%, esophagogastric junction in 34% and esophagus in 20%. 86% had metastatic disease. 43% progressed during previous CT, 28% progressed within 3 months of end of previous CT and 29% progressed between 3 and 6 months. 19 (23%) patients completed 6 CT cycles (median 3 cycles per patient). The main reasons for not completing treatment were progression and toxicity. Docetaxel significantly improved overall survival over ASC alone (median 5.2 months (95% CI 4.1-5.9 months) for docetaxel; 3.6 months (95% CI 3.3-4.4 months) for ASC, HR=0.67 (95% CI 0.49-0.92); p=0.01). 7% had a partial response and 46% had stable disease after CT. 21% on docetaxel had grade 4 toxicity. Conclusions: The addition of docetaxel to ASC significantly improved overall survival. Docetaxel can be considered a standard of care in this setting. Clinical trial information: 13366390.

scholarly journals Overall survival and quality of life in elderly patients treated for rectal cancer: results of a five year follow-up

BMC Surgery ◽  
2013 ◽  
Vol 13 (Suppl 1) ◽  
pp. A40
Author(s):  
Giovanni Romano ◽  
Francesco Moccia ◽  
Alfredo Allaria ◽  
Gianluca Rossetti ◽  
Domenico Napoletano ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Overall Survival ◽  
Elderly Patients

Flutamide Versus Prednisone in Patients With Prostate Cancer Symptomatically Progressing After Androgen-Ablative Therapy: A Phase III Study of the European Organization for Research and Treatment of Cancer Genitourinary Group

2001 ◽  
Vol 19 (1) ◽  
pp. 62-71 ◽  
Author(s):  
S. D. Fosså ◽  
P. H.Th. Slee ◽  
M. Brausi ◽  
S. Horenblas ◽  
R. R. Hall ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Overall Survival ◽  
Phase Iii ◽  
Biochemical Response ◽  
Life Questionnaire ◽  
Subjective Response ◽  
European Organization ◽  
Median Response

PURPOSE: Time to progression (TTP), overall survival, and quality of life (QL) were compared in patients with hormone-resistant prostate cancer (HRPC) treated with prednisone (5 mg orally, four times a day) or flutamide (250 mg orally, three times a day). PATIENTS AND METHODS: Symptomatic patients were randomized to receive either prednisone (101 patients) or flutamide (100 patients). Subjective response was assessed based on performance status, the use of analgesics, and the need to apply alternative palliative treatment. Prostate-specific antigen (PSA)–based biochemical response (≥ 50% reduction of baseline PSA) was recorded. At baseline and at 6-week intervals during follow-up, patients completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C-30. RESULTS: There was no difference between the groups in median TTP (prednisone, 3.4 months; flutamide, 2.3 months) or overall survival (prednisone, 10.6 months; flutamide, 11.2 months). In the prednisone group, 56% of the patients experienced a subjective response, compared with 45% in the flutamide group (P = .18). The median response duration was 4.8 months for prednisone and 4.2 months for flutamide. A biochemical response was observed in 21% and 23% of the prednisone and flutamide groups, respectively. Gastrointestinal toxicity was the reason for trial discontinuation in seven patients receiving flutamide and two patients receiving prednisone. The QL assessment parameters favored the use of prednisone with statistically significant differences in pain, fatigue, role functioning, appetite loss, gastrointestinal distress, and overall QL. CONCLUSION: In symptomatic HRPC, treatment with prednisone or flutamide leads to similar rates of TTP and overall survival and no difference in subjective or biochemical response. The QL results favor the use of low-cost prednisone in patients with HRPC.

scholarly journals ‘French LARS score’: validation of the French version of the low anterior resection syndrome (LARS) score for measuring bowel dysfunction after sphincter-preserving surgery among rectal cancer patients: a study protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e034251
Author(s):  
Yassine Eid ◽  
Véronique Bouvier ◽  
Olivier Dejardin ◽  
Benjamin Menahem ◽  
Fabien Chaillot ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Bowel Dysfunction ◽  
Self Report ◽  
Life Questionnaire ◽  
European Organization ◽  
Lars Score

IntroductionMany bowel problems following low anterior resection (LAR) for rectal cancer considerably impair the quality of life (QoL) of patients. The LAR syndrome (LARS) scale is a self-report questionnaire to identify and assess bowel dysfunction after rectal cancer surgery. It has been translated and validated in several languages but not in French (metropolitan French). The primary objective is to adapt the LARS scale to the French language (called French-LARS score) and to assess its psychometric properties. Secondary objectives are to assess both the prevalence and severity of LARS and to measure their impact on QoL.Methods and analysisA French multicentre observational cohort study has been designed. The validation study will include translation of the LARS scale following the current international recommendations, assessment of its reliability, convergent and discriminant validities, sensitivity, internal consistency, internal validity and confirmatory analyses. One thousand patients will be enrolled for the analyses. The questionnaire will be initially administered to the first 100 patients to verify the adequacy and degree of comprehension of the questions. Then reproducibility will be investigated by a test–retest procedure in the following 400 patients.An analysis will be conducted to determine the correlation between the LARS score and the Quality of Life Questionnaire (QLQ; European Organization for Treatment and Research of Cancer’s QLQ-C30, QLQ-CR29). Risk factors linked to QoL deterioration will be identified and their impact will be measured. This study will meet the need for a validated tool to improve patient care and QoL.Ethics and disseminationThe institutional review board of the University Hospital of Caen and the ethics committee (CPP Nord Ouest I, 25 January 2019) approved the study.Trial registration numberNCT03569488.

Phase II Trial of Palliative Radiotherapy for Hepatocellular Carcinoma and Liver Metastases

2013 ◽  
Vol 31 (31) ◽  
pp. 3980-3986 ◽  
Author(s):  
Hany Soliman ◽  
Jolie Ringash ◽  
Haiyan Jiang ◽  
Kawalpreet Singh ◽  
John Kim ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hepatocellular Carcinoma ◽  
Liver Metastases ◽  
Phase Iii ◽  
Life Questionnaire ◽  
The Past ◽  
Eortc Qlq C30 ◽  
Eortc Qlq

Purpose To evaluate the feasibility and response of liver radiotherapy (RT) in improving symptoms and quality of life in patients with hepatocellular carcinoma (HCC) or liver metastases (LM). Patients and Methods Eligible patients had HCC or LM, unsuitable for or refractory to standard therapies, with an index symptom of pain, abdominal discomfort, nausea, or fatigue. The Brief Pain Inventory (BPI), Functional Assessment of Cancer Therapy–Hepatobiliary (FACT-Hep), and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) were completed by patients at baseline and each follow-up. The primary outcome was the percentage of patients with a clinically significant change at 1 month in the BPI subscale of symptom on average in the past 24 hours. Secondary outcomes were improvement in other BPI subscales and at other time points, FACT-Hep and EORTC QLQ-C30 at each follow-up, and toxicity at 1 week. Results Forty-one patients (30 men and 11 women) with HCC (n = 21) or LM (n = 20) were accrued. At 1 month, 48% had an improvement in symptom on average in the past 24 hours. Fifty-two percent of patients had improvement in symptom at its worst, 37% at its least, and 33% now. Improvements in the FACT-G and hepatobiliary subscale were seen in 23% and 29% of patients, respectively, at 1 month. There were also improvements in EORTC QLQ-C30 functional (range, 11% to 21%) and symptom (range, 11% to 50%) domains. One patient developed grade 3 nausea at 1 week. Conclusion Improvements in symptoms were observed at 1 month in a substantial proportion of patients. A phase III study of palliative liver RT is planned.

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