Longitudinal trajectory of cancer survivorship in patients with recurrent rectal cancer: Anatomy of recurrence in relation to quality of life and pain.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 679-679
Author(s):  
Tarik Sammour ◽  
Songphol Malakorn ◽  
George J. Chang ◽  
Miguel A. Rodriguez-Bigas ◽  
Brian Bednarski ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Cancer Survivorship ◽  
Recurrent Rectal Cancer ◽  
Pain Scores ◽  
Patient Reported ◽  
Eortc Qlq ◽  
Surgical Salvage

679 Background: Multiple treatment modalities are utilized for patients with recurrent rectal cancer (RRC). While recurrent pelvic tumor can be highly symptomatic, treatments often carry significant morbidity risks. Patient reported outcomes such as quality of life (QoL) and pain can supplement traditional clinical endpoints in assessing the effectiveness of salvage treatments, and thus aid in treatment decision making. We aimed to examine the longitudinal trajectory of cancer survivorship in RRC. Methods: A prospective protocol enrolled patients diagnosed with RRC between 2008 and 2015. Participants prospectively self-reported QoL (measured by the validated EORTC QLQ-C30 and EORTC QLQ-CR29) and pain (measured by the Brief Pain Inventory, BPI), at presentation, and then every 6 months for 5 years. After accounting for repeated measures, trajectory of mean scores over time was assessed for patients amenable to surgical salvage vs those who were not, using linear mixed-effects modeling. Results: A total of 104 patients were enrolled of which 73 (70.2%) were amenable to salvage surgery with curative intent. Surgical salvage was associated with 30 day morbidity of 68.5% (13.7% and 5.5%, Grade 3 and 4 respectively). Three year overall survival was 56.7% (68.5% in surgical and 29.0% in non-surgical patients). Mean baseline QoL scores did not differ between surgical vs nonsurgical patients but were significantly impacted by the anatomical site of recurrent disease (lowest scores in posterior pelvic recurrence; P=0.012). On longitudinal analysis with a median followup of 33 months, surgically salvaged patients showed gradual sustained improvement in QoL but not pain scores. Anatomy of initial recurrence had an ongoing impact on QoL long term with posterior recurrences having the worst scores. Both QoL and pain scores worsened in patients not amendable to surgical salvage. Conclusions: Disease anatomy determines QoL at baseline and long term in patients with RRC. Surgery improves QoL but not pain in selected resectable cases.

Pain and Quality of Life After Treatment in Patients With Locally Recurrent Rectal Cancer

2002 ◽  
Vol 20 (21) ◽  
pp. 4361-4367 ◽  
Author(s):  
Nestor F. Esnaola ◽  
Scott B. Cantor ◽  
Margo L. Johnson ◽  
Attiqa N. Mirza ◽  
Alexander R. Miller ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Management Strategies ◽  
Brief Pain Inventory ◽  
Recurrent Rectal Cancer ◽  
Locally Recurrent Rectal Cancer ◽  
Pain Scores ◽  
Pelvic Tumors ◽  
Locally Recurrent

PURPOSE: Because survival in patients with locally recurrent rectal cancer (LRRC) is limited, pain control and quality of life (QOL) are important parameters. The purpose of this study was to assess the prevalence of posttreatment pain and QOL of patients with LRRC treated with nonsurgical palliation or resection and identify predictors of poor outcome. PATIENTS AND METHODS: Posttreatment pain severity and QOL were prospectively assessed in 45 patients with LRRC using the Brief Pain Inventory and Functional Assessment of Cancer Therapy–Colorectal questionnaire. RESULTS: Fifteen patients received nonsurgical palliation, and 30 patients underwent resection of their pelvic tumors. There was a significant association between higher posttreatment pain scores and worse QOL (P < .001). Patients treated with nonsurgical palliation reported moderate to severe pain beyond the third month of treatment. Resected patients reported comparable levels of pain during the first 3 postoperative years, particularly after bony resections; long-term survivors (beyond 3 years), however, reported minimal pain and good QOL. Female sex, pelvic/sciatic pain at presentation, total pelvic exenteration, and bony resection were associated with higher rates of moderate to severe posttreatment pain (P = .04, P < .001, P = .04, and P = .02, respectively). Pain at presentation was an independent predictor of posttreatment pain (odds ratio, 7.4 [95% confidence interval, 1.8 to 30.3]; P = .006). CONCLUSION: Patients with LRRC treated with nonsurgical palliation or resection experience significant levels of pain after treatment. Close posttreatment pain monitoring is warranted in patients presenting with pelvic pain, and more aggressive pain management strategies may improve posttreatment QOL.

scholarly journals Long-Term Quality of Life of Acute Promyelocytic Leukemia Patients Treated with Arsenic Trioxide versus Chemotherapy

2021 ◽  
Author(s):  
Fabio Efficace ◽  
Uwe Platzbecker ◽  
Massimo Breccia ◽  
Francesco Cottone ◽  
Paola Carluccio ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Arsenic Trioxide ◽  
Acute Promyelocytic Leukemia ◽  
Promyelocytic Leukemia ◽  
Sf 36 ◽  
Patient Reported ◽  
Eortc Qlq C30 ◽  
Eortc Qlq

The main objective of this study was to compare the long-term health-related quality of life of patients with acute promyelocytic leukemia (APL) treated with all-trans retinoic acid (ATRA) plus arsenic trioxide (ATO) versus ATRA plus standard chemotherapy. Patients previously enrolled in the randomized controlled trial APL0406 were considered eligible for this follow-up study. The following patient-reported outcome measures were used: the EORTC QLQ-C30, the EORTC QLQ-CIPN20 and the SF-36. The prevalence of late comorbidities and health problems was also assessed. The clinical significance of differences was evaluated based on predefined thresholds. This study was registered at ClinicalTrials.gov (NCT03096496). One hundred sixty-one out of 232 potentially eligible patients were analyzed, of whom 83 were treated with ATRA-ATO and 78 were treated with ATRA-chemotherapy. The median time since diagnosis of the study sample was 8 years. The two largest clinically meaningful differences in the EORTC QLQ-C30 were observed for role functioning (Δ=8.4, 95% CI, 0.5 to 16.3) and dyspnea (Δ=-8.5, 95% CI, -16.4 to -0.7), favoring patients treated with ATRA-ATO. With regard to the SF-36 results, a clinically relevant better physical component score (Δ=4.6, 95% CI, 1.3 to 7.8) was observed in patients treated with ATRA-ATO, but this was not the case for the mental component score. The two groups showed similar profiles in the scores of the EORTC QLQ-CIPN20 scales and in the prevalence of late comorbidities. Overall, our findings suggest that the greater and more sustained antileukemic efficacy of ATRA-ATO is also associated with better long-term patient-reported outcomes than ATRA-chemotherapy.

scholarly journals Prospective observational study to examine health-related quality of life and develop models to predict long-term patient-reported outcomes 6 months after hospital discharge with blunt thoracic injuries

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e049292
Author(s):  
Edward Baker ◽  
Ceri Battle ◽  
Abhishek Banjeri ◽  
Edward Carlton ◽  
Christine Dixon ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hospital Discharge ◽  
Brief Pain Inventory ◽  
Thoracic Injuries ◽  
Patient Reported ◽  
Related Quality ◽  
Paindetect Questionnaire ◽  
Health Related

ObjectiveThis study aimed to examine the long-term outcomes and health-related quality of life in patients with blunt thoracic injuries over 6 months from hospital discharge and develop models to predict long-term patient-reported outcomes.DesignA prospective observational study using longitudinal survey design.SettingThe study recruitment was undertaken at 12 UK hospitals which represented diverse geographical locations and covered urban, suburban and rural areas across England and Wales.Participants337 patients admitted to hospital with blunt thoracic injuries were recruited between June 2018–October 2020.MethodsParticipants completed a bank of two quality of life surveys (Short Form-12 (SF-12) and EuroQol 5-Dimensions 5-Levels) and two pain questionnaires (Brief Pain Inventory and painDETECT Questionnaire) at four time points over the first 6 months after discharge from hospital. A total of 211 (63%) participants completed the outcomes data at 6 months after hospital discharge.Outcomes measuresThree outcomes were measured using pre-existing and validated patient-reported outcome measures. Outcomes included: Poor physical function (SF-12 Physical Component Score); chronic pain (Brief Pain Inventory Pain Severity Score); and neuropathic pain (painDETECT Questionnaire).ResultsDespite a trend towards improving physical functional and pain at 6 months, outcomes did not return to participants perceived baseline level of function. At 6 months after hospital discharge, 37% (n=77) of participants reported poor physical function; 36.5% (n=77) reported a chronic pain state; and 22% (n=47) reported pain with a neuropathic component. Predictive models were developed for each outcome highlighting important data collection requirements for predicting long-term outcomes in this population. Model diagnostics including calibration and discrimination statistics suggested good model fit in this development cohort.ConclusionsThis study identified the recovery trajectories for patients with blunt thoracic injuries over the first 6 months after hospital discharge and present prognostic models for three important outcomes which after external validation could be used as clinical risk stratification scores.

Quality of Life Among Disease-Free Survivors of Rectal Cancer

2004 ◽  
Vol 22 (2) ◽  
pp. 354-360 ◽  
Author(s):  
Philippe Rauch ◽  
Joelle Miny ◽  
Thierry Conroy ◽  
Lionel Neyton ◽  
Francis Guillemin
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Cancer Survivors ◽  
German Population ◽  
European Organization ◽  
Eortc Qlq C30 ◽  
Eortc Qlq ◽  
The Impact ◽  
Disease Free

Purpose To identify factors affecting the quality of life (QoL) of disease-free survivors of rectal cancer. Patients and Methods One hundred twenty-one patients in complete remission more than 2 years after diagnosis were asked to complete three QoL questionnaires: the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30; its colorectal module, QLQ-CR38; and the Duke generic instrument. Results Patients reported less pain (P = .002) than did controls drawn from the general population. EORTC QLQ-C30 physical scores were also higher among rectal cancer survivors than in the general Norwegian or German population (P = .0005 and P = .002, respectively). Unexpectedly, stoma patients reported better social functioning than did nonstoma patients (P = .005), with less anxiety (P = .008) and higher self-esteem (P = .0002). In the present authors' experience, the QLQ-CR38 does not discriminate between these groups. Residual abdominal or pelvic pain and constipation had the most negative influence on QoL. Conclusion QoL is high among rectal cancer survivors, including stoma patients. Simultaneous use of several QoL questionnaires appears to have value in follow-up and in monitoring the effects of therapy. The impact of residual pain and constipation on long-term QoL should be considered when establishing a treatment regimen.

scholarly journals Long-Term Health-Related Quality of Life in Patients With Rectal Cancer After Preoperative Short-Course and Long-Course (Chemo) Radiotherapy

2016 ◽  
Vol 15 (3) ◽  
pp. e93-e99 ◽  
Author(s):  
Lisette M. Wiltink ◽  
Remi A. Nout ◽  
Jochem R.N. van der Voort van Zyp ◽  
Heleen M. Ceha ◽  
Marta Fiocco ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Health Related Quality ◽  
Short Course ◽  
Related Quality ◽  
Health Related ◽  
Long Course

scholarly journals Factors associated with depression and the relationship to quality of life among Saudi women with breast cancer

2020 ◽  
Vol 11 (4) ◽  
pp. 43
Author(s):  
Monefah Al-Shammari ◽  
Amani Khalil
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Life Questionnaire ◽  
Primary Therapy ◽  
Convenience Sample ◽  
Saudi Women ◽  
Patient Reported ◽  
Eortc Qlq ◽  
The Relationship

Background and objective: Breast cancer is the most common malignancy among women worldwide, diagnosis and treatment and the months following primary therapy associated with different psychological symptoms that affect quality of life (QoL) in most women with breast cancer. The aim of this study was to identify the relationship between depression and quality of life QoL among Saudi women with breast cancer.Methods: Design: This is a descriptive, cross-sectional study. Methods: A convenience sample of 370 women with breast cancer was recruited from the out-clinic in King Faisal Specialist Hospital \& Research Center (KFSH&RC). Data were collected using self-report tools derived from the Patient-Reported Outcomes Measurement Information System (PROMIS) Emotional Distress-Depression-Short Form; the EORTC quality of life questionnaire (QLQ) (EORTC QLQ-C30, v.3.0 and EORTC QLQ-BR23); and from the Demographic and Clinical Data Sheet.Results: The correlation between depression and global health status with functioning subscales for the women was negative (Pearson’s r = -.357, p < .001; r = -.368, p < .001); whereas a positive correlation was found between depression and symptom subscales, together with its items.Conclusions: This study shows that depression is associated with QoL among Saudi women diagnosed with breast cancer. Therefore, depression affects upon QoL among the breast cancer population. However, enhancement of mental health statuses and psychological interventions helps to reduce the severity of depression and improves health related QoL among this population.

scholarly journals Psychosocial Aspects and Quality of Life in Cancer Patients undergoing Surgery

2021 ◽  
Vol 12 (4) ◽  
pp. 78-84
Author(s):  
M. Bakos ◽  
T. Jankovic ◽  
M. Vidiscak ◽  
S. Durdik
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Negative Impact ◽  
European Organization ◽  
Term Survival ◽  
Physical Relationship ◽  
End Of Treatment ◽  
Eortc Qlq

Introduction:Quality of life in cancer patients and probably also long term survival is negatively affected with fear of the recurrence of cancer and consequences of aggressive therapy. This is the reason for anxiety, depressions, and frustration which are accompanied by cognitive, emotional and behavioral disorders in their physical, relationship, sexual and social func- tioning. The aim of our study is to analyze the dynamics of evolution of the psychosocial loads and qualitative changes its symptomatology in cancer patients who survival 1-4 years after surgery. Material and methods:For assessment of psychosocial mor- bidity ́s in measure in surgery patients standardized question- naires of European Organization for Research and Treatment of Cancer- questionnaire EORTC QLQ-C30.3 (Quality of Life- C.30.3) and its module EORTC QLQ- BR23 were used. Results:The degree of psychosocial mortality in survival pa- tients one year after MRM in our group clearly demonstrated that these patients suffered because of consequences of psy- chosocial loads. It results from fear of recurrence of cancer and next functional, emotional, cognitive and social disorders with- out regard for surgery range. The degree of psychosocial loads in patients after MRM is still more than 4 years after end of treatment. Results show, that after the end of treatment there are many changes in their lives - anxiety and depressions can lead to psychical lability because of higher doubts, nervous- ness, irritability, helplessness and loneliness in their sufferers. Conclusion:Out-patient psychosocial interventions and pre- ventions because of negative impact of ongoing and changing psychosocial loads becomes necessary. It means that there is negative impact on quality of life; of long term cancer remis- sion and survival of patients after surgery.

scholarly journals Determinants of Cancer-specific Quality of Life in Veteran Lung Cancer Survivors Eligible for Long-Term Cure

2019 ◽  
Author(s):  
Duc Ha ◽  
Andrew L. Ries ◽  
Jeffrey J. Swigris
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Cancer Survivors ◽  
Summary Score ◽  
European Organization ◽  
Specific Patient ◽  
Patient Reported ◽  
Sleep Difficulties

AbstractRationale/ObjectiveQuality of life (QoL) is an important issue in lung cancer survivors. We aimed to identify determinants of QoL in lung cancer survivors eligible for long-term cure.MethodsWe performed an exploratory analysis of a cross-sectional study of consecutive lung cancer survivors who completed curative-intent treatment ≥1 month previously. Variables tested included demographic, clinical, physiologic, and symptom-specific patient-reported outcome measures. We defined the primary outcome as a previously-validated cancer-specific QoL measure – the European Organization for Research and Treatment of Cancer QoL Questionnaire Core 30 (C30) summary score. We also verified our findings with the C30 global health status/QoL subscale and a summated score of lung cancer-specific QoL from the EORTC-Lung Cancer Module 13.ResultsIn 75 enrolled participants, measures of fatigue, depression, sleep difficulties, and dyspnea were statistically significant determinants of the C30 summary score in multivariable linear regression analyses. Together, these four symptoms accounted for approximately 85% of the variance in cancer-specific QoL (p<0.001). When we verified our findings with global QoL and lung cancer-specific QoL, fatigue and dyspnea were consistent determinants of QoL.ConclusionsWe found four symptoms – dyspnea, fatigue, depression, and sleep difficulties – that are important determinants of and together accounted for almost all of the variance in cancer-specific QoL in lung cancer survivors eligible for long-term cure. These findings have implications to reduce symptom burden and improve function and QoL in these patients.

scholarly journals Concerns and Quality of Life of Cancer Survivors Across the Survivorship Trajectory: A Singapore Perspective

2019 ◽  
Author(s):  
Gek Phin Chua ◽  
Quan Sing Ng ◽  
Hiang Khoon Tan ◽  
Whee Sze Ong
Keyword(s):  
Quality Of Life ◽  
Cancer Survivors ◽  
Cancer Treatment ◽  
Cancer Survivorship ◽  
Recurrence Risk ◽  
Term Treatment ◽  
Fear Of Recurrence ◽  
Long Term Treatment

Abstract Background The aim of this study is to determine the main concerns of survivors at various stages of the cancer survivorship of the cancer survivorship trajectory and to assess whether these concerns have any effect on their quality of life (QOL). The overall goal was to use the insights from the study to guide practice on patient care. Methods A cross-sectional survey of 1107 cancer survivors diagnosed with colorectal, breast, lung, gynaecological, prostate or liver cancers from a cancer centre in Singapore. Eligible patients self-completed a questionnaire adapted from the Mayo Clinic Cancer Centre’s Cancer Survivors Survey of Needs. Results The top 5 concerns among all survivors were cancer treatment and recurrence risk (51%), followed by long-term treatment effects (49%), fear of recurrence (47%), financial concerns (37%) and fatigue (37%). Cancer treatment and recurrence risk, long-term treatment effects and fear of recurrence were amongst the top concerns across the survivorship trajectory. Mean QOL was 7.3 on a scale of 0 – 10. Completed treatment patients had higher QOL score than the newly diagnosed and on treatment patients and the patients dealing with recurrence or second cancer patients. Predictors for QOL included the economic status and housing type of patients and whether patients were concerned with pain and fatigue Conclusion This study confirms that cancer survivors in Singapore face multiple challenges and had various concerns at various stages of cancer survivorship, some of which negatively affect their QOL It is critical to design patient care delivery that appropriately address the various concerns of cancer survivors in order for them to cope and improve their QOL.

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