The Effect of Hallux Valgus Surgery on Quality of Life

Background Health-related quality of life (QOL) is defined as a patient's subjective perception of his or her own health. Insufficient data exist on QOL of patients who undergo a hallux valgus (HV) operation. We used a 36-item short form survey (SF-36) to measure QOL of such patients. Our aim was to evaluate the effect of HV on QOL and to identify QOL determinants. Methods Fifty patients who underwent surgery for HV between 2015 and 2017 were included in the study. The SF-36 questionnaire was applied to the patients before and after surgery. Patients' medical records were examined to identify possible factors affecting QOL such as age, gender, body mass index, duration of symptoms, or smoking. Results The mean age of the patients was 55.6 ± 3.8 years, and 42 of the 50 patients were women. The mean duration of disease was 12 ± 3.7 years. The surgery improved QOL scores for general health, emotional well-being, role limitations due to personal or emotional problems, physical functioning and bodily pain. However, the changes in scores for vitality and social functioning were not statistically significant. Lower postoperative QOL scores for emotional well-being and bodily pain were significantly associated with age and duration of the symptoms. Compared to the mean QOL of healthy adult Turkish population, all scores in subdimensions were lower. Conclusions This study shows that HV in adults has a negative impact on general health, bodily pain, physical functioning, physical and emotional well-being rather than social well-being and vitality.

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A functional electric orthesis on the paretic leg improves quality of life of stroke patients

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2006000100005 ◽

2006 ◽

Vol 64 (1) ◽

pp. 20-23 ◽

Cited By ~ 9

Author(s):

Mara Renata Fernandes ◽

Luciane B.C. Carvalho ◽

Gilmar F. Prado

Keyword(s):

Quality Of Life ◽

Social Functioning ◽

Physical Functioning ◽

Bodily Pain ◽

Improve Quality ◽

Stroke Patients ◽

Normal Life ◽

Sf 36 ◽

Before And After

CONTEXT: Hemiparesia changes quality of life of patients with stroke making difficult a normal life. OBJECTIVE: To evaluate the effect of Functional Eletric Orthesis (FEO) applied over the paretic leg in the quality of life of stroke patients. METHOD: The quality of life of 50 stroke patients of Associacao de Assistencia a Crianca Deficiente (AACD) was evaluated with SF-36 questionnaire before and after the treatment with a FEO for rehabilitation of walking. We analyzed data according to gender and affected hemisphere. RESULTS: The average values from all domains of SF-36 improved significantly (p<0.001). Female patients improved more than male in Emotional Domain (p=0.04) and presented a trend to be better regarding Bodily Pain and Social Functioning. Patients with right hemiparesia improved more than those with left hemiparesia (p=0.02). CONCLUSION: FEO over a paretic leg is efficient to improve quality of life of stroke patients, mainly Physical Functioning.

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Quality of life during the first 6 months of interferon-b treatment in patients with MS

Multiple Sclerosis Journal ◽

10.1177/135245850000600508 ◽

2000 ◽

Vol 6 (5) ◽

pp. 338-342

Author(s):

J HA Arnoldus ◽

J Killestein ◽

L EMA Pfennings ◽

B Jelles ◽

B MJ Uitdehaag ◽

...

Keyword(s):

Quality Of Life ◽

Depressive Symptoms ◽

Side Effects ◽

Physical Functioning ◽

Bodily Pain ◽

Significant Linear Trend ◽

Role Physical ◽

Sf 36 ◽

The Impact

Objectives: To determine the quality of life (QoL) of MS patients during the initial 6 months of treatment with interferon-b (IFN-b). Furthermore, to determine whether changes in QoL relate to disability, emotional state, therapeutic expectations or side effect profile. Background: IFN-b has been shown to have beneficial effects on the course of MS. Since the aim of IFN-b treatment is not to cure but to slow down the disease it is important to know how this treatment affects QoL. Surprisingly, the impact of treatment with IFN-b on QoL measures has not been extensively studied so far. Methods: Case report documentation, including EDSS, SF-36 and MADRAS scores, of 51 relapsing-remitting MS patients treated with IFN-b was obtained at baseline and at months 1, 3 and 6. Patients also filled in a form about their expectations of therapy and a questionnaire on side effects. Results: During treatment there was a significant linear trend indicating improvement in the role-physical functioning (RPF) scale of the SF-36 (F1,50=4.9, P=0.032). A transient decrease at month 1 was found in the scale for bodily pain, indicating more experienced pain (F1,50=19.8, P50.001). Subgroup analysis showed that patients with most depressive symptoms on the MADRAS at baseline contributed most to the increase in RPF scores over time (F1,24=5,6 P=0.026). Furthermore, we found associations between adverse event scores and several domains of QoL. Conclusions: Our findings suggest that IFN-b therapy has an impact on QoL of MS patients in that it improves role-physical functioning and transiently worsens experienced bodily pain. QoL during treatment with IFN-b is influenced by depressive symptoms at baseline as well as by treatment-associated side-effects.

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To assess the quality of life in patients with chronic kidney disease undergoing hemodialysis at a satellite clinic, comparing patients from a median low-income household with patients from median middle- and upper-income households: cross-sectional study

10.21203/rs.2.19931/v1 ◽

2020 ◽

Author(s):

UBIRACE FERNANDO ELIHIMAS JUNIOR ◽

Marília Costa Aranha Forte ◽

Alexandre Holanda Cavalcanti Pinto ◽

Eduardo Eriko Tenório de França ◽

Jamila Pinho Couto ◽

...

Keyword(s):

Quality Of Life ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Low Income ◽

Physical Functioning ◽

General Health ◽

Positive Association ◽

Hemodialysis Treatment ◽

Sf 36

Abstract Background: Chronic kidney disease is a financial challenge for global public health due to rising costs, a poorer quality of life. Globally, there has been an increase in the number of diabetic, hypertensive and obese patients, with a tendency to rise as life expectancy increases. Objective: To assess the quality of life of patients with chronic kidney disease on hemodialysis at a satellite clinic in Recife, Northeast Brazil, and comparing low-income patients funded by the national healthcare system with middle- and higher-income patients funded by private health insurance. Methods: The Medical Outcomes Study Questionnaire Short Form 36 Health Survey (SF-36) was applied, together with a complementary interview with socio-demographic data for all patients at a conventional hemodialysis clinic. All patients were submitted to the same hemodialysis protocol, 4 hours and 10 minutes, high flow biocompatible membranes with high mass transfer coefficient and an adequacy of Kt/V ≥1.2. Results: The poorest quality of life scores with the SF-36 were related to physical functioning and pain. The best scores were attributed to mental health, social functioning, general health and vitality with no differences between the household incomes. There was a positive association between education, role-emotional and physical functioning. Longer hemodialysis treatment times demonstrated a positive association with aspects of general health. Patients who had undergone hemodialysis between one and five years presented better quality of life scores with the SF-36. Conclusions: Hemodialysis treatment negatively influences the quality of life of patients with chronic kidney disease. Education seems to help patients to better understand and accept treatment, by raising the scores of the physical functioning and role-physical. The first year of hemodialysis seems to exert a more negative influence on the quality of life. Among all patients, pain and physical aspects seem to be the critical points, regardless of social class or income.

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AB0064 EVALUATION OF QUALITY OF LIFE IN RHEUMATOID ARTHRITIS USING SF-36 AND HAQ SCALES

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.3309 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1063.1-1063

Author(s):

M. Brahem ◽

M. Hassayoun ◽

H. Hachfi ◽

R. Sarraj ◽

M. Ardhaoui ◽

...

Keyword(s):

Quality Of Life ◽

Rheumatoid Arthritis ◽

Disease Activity ◽

Short Form ◽

Bodily Pain ◽

Global Score ◽

Sf 36 ◽

The Mean ◽

The Impact

Background:The assessment of health-related quality-of-life (HRQoL) in rheumatoid arthritis (RA) is becoming a common tool in clinical practice. The medical outcomes survey short form 36 (SF- 36) is one of the most widely used tools for measuring HRQoL in RA as well as the HAQ scale.Objectives:The aim of our study is to evaluate the impact of the RA in the quality of life (QoL) of our patients using the SF-36 and the HAQ questionnaires.Methods:This is a cross-sectional study during a period of the year 2020, including 70 patients followed in the department of Rheumatology in Mahdia, Tunisia. All patients were diagnosed with RA based in ACR 1987/EULAR 2010. We evaluated for each patient, the mean global scale and the eight domains of SF-36 (physical functioning (PF), role physical (RP), bodily pain (BP), general health (GH), vitality (VT), a social functioning (SF), role emotional (RE) and mental health (MH)), scored from 0 (worst) to 100 (best).Results:Our study included 70 patients (59 females/11males) with an age ranged from 21 to 76 years. The mean age was 54 ± 12 years. The mean duration of the disease was 11 ± 10 years [1-40]. The mean number of tender joints was 9.7 ±9.4 and swollen joints were 4.2 ±6.1. The mean disease activity score (DAS28) was 4.6 ±1.9 [1.2-8.4]. The mean HAQ score was 1.5±1.3, 47.1% of patients had specific joint deformations, 82.9% had radiologic involvement and 31.4% had osteoporosis. The biologic analysis showed that the mean ESR was 46.7 ± 30.5 and the CRP was 15.8 ±23.3. Rheumatoid factors were positive in 42.9% of cases, the ACPA were positive in 50% of cases. 84.3% of RA patients were treated by methotrexate, 4.3% were treated by salazopyrin and 11.4% were treated by biologic treatments.The SF-36 global score was 50.4 ± 26.3 [15.3-92.8]. 46 patients (65.7% of cases) had impaired QoL (SF-36<66.7). The means of different domains (PF, RP, BP, GH, VT, SF, RE, MH) were respectively 51; 41.4; 51.4; 50; 51.2; 57.7; 41.9; 59.2. The most severely impacted domains were the RP and RE.Our study showed a significant correlation between the SF-36 global score and the number of tender joints (p=0.002), the DAS28 (p=0.017) and the HAQ(p=0.000).Conclusion:Our study showed that 65.7% of RA patients presented impaired QoL (SF-36<66.7), which is associated with high disease activity. So it’s important to jugulate the disease, in order to ameliorate the quality of life of our patients.References:[1]Matcham, F., Scott, IC, Rayner, L., Hotopf, M., Kingsley, GH, Norton, S.,… Steer, S. (2014). L’impact de la polyarthrite rhumatoïde sur la qualité de vie évalué à l’aide du SF-36: une revue systématique et une méta-analyse. Séminaires sur l’arthrite et les rhumatismes, 44 (2), 123-130. doi: 10.1016 / j.semarthrit.2014.05.001.Disclosure of Interests:None declared

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The influence of caregivers’ burden on the quality of life for caregivers of older adults with chronic illness in Nigeria

International Psychogeriatrics ◽

10.1017/s1041610216002295 ◽

2017 ◽

Vol 29 (7) ◽

pp. 1085-1093 ◽

Cited By ~ 2

Author(s):

Joel Olayiwola Faronbi ◽

Adenike Ayobola Olaogun

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Chronic Illness ◽

Social Functioning ◽

Physical Functioning ◽

General Health ◽

Well Being ◽

Role Limitation ◽

The Impact

ABSTRACTBackground:This study investigated the impact of caregivers’ burden on health-related quality of life (HRQoL) among the caregivers of older adults, and tested the predictive effect of burden and socio-demographic factors on HRQoL.Methods:The study employed a cross-sectional design. Three hundred and twenty-five caregivers of older adults with chronic illness were purposively selected. Data were collected using the Zarit Burden Interview and Short Form (SF-36) Health Survey. Data were analyzed descriptively and inferentially.Results:Findings revealed that 59.1% of caregivers experienced severe burden. In measuring the HQRoL, respondents performed poorly in seven domains: Role limitation due to emotional problems (19.69 ± 9.46), Energy/fatigue (43.47 ± 16.46), Emotional well-being, (45.83 ± 13.93), Social functioning (49.09 ± 18.46), Role limitation due to physical function (43.33 ± 10.15), Physical functioning (43.6 ± 18.73), and General health (37.31 ± 12.09). Respondents, however, showed a higher score in the pain domain (56.77 ± 35.79). Furthermore, findings revealed a positive correlation between caregivers’ burden and General health (r = 0.342), Emotional well-being (r = 0.222), and Physical functioning (r = 0.083). Similarly, there is a negative correlation between caregivers’ burden and Social functioning (r = –0.618), Role limitation due to physical activities (r = 0.459), Role limitation due to emotional well-being (r = –0.530), and Energy/fatigue domains (r = –0.509). In addition, burden of caregiving (β=–3.142119, p = 0.000) and age (β=0.612752, p = 0.011) are predictors of the quality of life of caregivers.Discussion:This study concluded that there is a high prevalence of caregivers’ burden resulting in poor HQRoL. In addition, burden and age are predictors of the quality of life of caregivers.

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Relation Between Clinical Oral Health Status, Oral Health Related Quality of Life, Denture Material Type and Self-perceived General Health, in a General Population

Revista de Chimie ◽

10.37358/rc.19.9.7541 ◽

2019 ◽

Vol 70 (9) ◽

pp. 3315-3324

Author(s):

Alexandru Gratian Grecu ◽

Andra Elena Aungurencei ◽

Dan Lucian Dumitrascu

Keyword(s):

Quality Of Life ◽

Oral Health ◽

General Health ◽

Oral Health Status ◽

Health Related Quality ◽

Sf 36 ◽

Related Quality ◽

Health Related ◽

The Mean

The purpose of the current study was to assess the oral health related quality of life (OHRQoL), general health related quality of life (HRQoL), clinical oral and denture status, as well as their interrelation, within a hospitalized general population. The Romanian versions of the Oral Health Impact Profile-49 (OHIP-49Ro), SF-36 questionnaires, together with an additional set of oral health assessment questions, were administered under the interview format to 170 patients, hospitalized in the Second Medical Clinic of Internal Medicine, Cluj-Napoca, Romania. The patients also underwent clinical examination, based on which the DMFT was calculated. Denture status, was as well, registered, together with the denture material. Each patient provided informed consent, prior to any examination. Questionnaire scores were calculated and used for the univariate descriptive statistics, reflecting oral health, OHRQoL and HRQoL sample tendencies. Successively, multiple regression analysis was applied, with the purpose of investigating the relationship between: the clinical oral health status, OHRQoL and HRQoL. In the first model, OHRQoL, while in the second model the dependent variable was represented by the HRQoL, each having a set of established predictors. Additionally, for denture wearing patients, OHRQoL variations in respect to the denture material were assessed, using one-way ANOVA. The mean OHIP-49Ro overall score was 31.90. The mean SF-36 subscales score was 60.66. The mean DMFT score was 18.47. For both regression analyses, all the regression models were significant. For the first model, the predictors accounted for 48.5% of variance in OHRQoL. For the second model, the highest percent of variance, explained by the predictors, was registered for the Mental Health subscale (22.8%). DMFT, as a clinical measure, was a statistically significant predictor rather for the perception in general health. However, OHRQoL was a good predictor for HRQoL, as an integrated part of it. Moreover, the one-way ANOVA indicated statistically significant differences in OHRQoL perception, in respect to the denture material F(2, 82) = 3.253, p = 0.044. The current study indicated complex relations between the patients� clinical status, the OHRQoL and HRQoL. The clinical determinants presented direct impact on both OHRQoL and HRQoL. More balanced HRQoL scores suggested that patients focused more on the perception of general health outcomes.

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Quality of Life Assessment at Diagnosis and after Different Treatment Phases in Multiple Myeloma Brazilian Patients

Blood ◽

10.1182/blood.v112.11.5154.5154 ◽

2008 ◽

Vol 112 (11) ◽

pp. 5154-5154

Author(s):

Vanderleia Costa Silva ◽

Manuella Sampaio Almeida ◽

Vania T. M. Hungria ◽

Leina Yukari Etto ◽

José Salvador Rodrigues de Oliveira ◽

...

Keyword(s):

Quality Of Life ◽

Multiple Myeloma ◽

Physical Functioning ◽

Bodily Pain ◽

Life Assessment ◽

Cell Transplant ◽

Specific Questionnaire ◽

Generic Questionnaire ◽

Sf 36

Abstract Multiple myeloma (MM) causes great impact in quality of life (Q/L), since patients become dependant of others even for routine activity execution and personal care. Objectives: To characterize the impact of MM in the Q/L of patients treated in two public institutions of Sao Paulo State, Brazil, using a generic (SF-36) and a specific questionnaire for oncologic patient (QLQ-C30), applied in three different moments: at diagnosis, after the end of clinical treatment and at day +100 after autologous hematopoietic stem cell transplant (ASCT). Patients and methods: From March 2006 to August 2007 we evaluated 49 patients with MM, using the two questionnaires. Analysis was made through ANOVA, Post hoc and T-paired test comparing the three groups. Results: 88.6% of included patients have family budget lower than US$ 600.00/month (Economic Class C, D or E). The generic questionnaire SF-36 demonstrated that Physical Functioning, Role-Physical and Bodily Pain were statistically different in all three groups, favoring the day +100 post-ASCT group (ANOVA). SF-36 still demonstrated improvement in Role-Emotional when MM post treatment group was compared with the day + 100 post-ASCT group (T-paired Test). The QLQ-C30 questionnaire confirmed what had been demonstrated by the SF-36 in relation to the Physical Functioning and Bodily Pain plus improvement in the following aspects: Role Functioning, Fatigue, Lack of Appetite and Constipation, favoring the day + 100 post-ASCT group (ANOVA). QLQ-C30 also detected a significant improvement in Social Aspect in patients with MM after day +100 of ASCT. Conclusion: The specific questionnaire for cancer patients QLQ-C30 seems to be more informative than the generic questionnaire SF-36 and reflects the real benefit of ASCT in Q/L of MM patients from two public Brazilian institutions, which provide assistance for economically challenged population.

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Quality of Life in Hypoparathyroidism Improves With rhPTH(1-84) Throughout 8 Years of Therapy

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2018-02430 ◽

2019 ◽

Vol 104 (7) ◽

pp. 2748-2756 ◽

Cited By ~ 6

Author(s):

Gaia Tabacco ◽

Yu-Kwang Donovan Tay ◽

Natalie E Cusano ◽

John Williams ◽

Beatriz Omeragic ◽

...

Keyword(s):

Quality Of Life ◽

Short Form ◽

Calcium Supplementation ◽

Bodily Pain ◽

Well Being ◽

Reference Population ◽

Open Label ◽

Sf 36

Abstract Context Calcium and vitamin D treatment does not improve reduced quality of life (QOL) in hypoparathyroidism. Recombinant human (rh) PTH(1-84) therapy improves QOL metrics for up to 5 years. Data on QOL beyond this time point are not available. Objectives To evaluate the effects of 8 years of rhPTH(1-84) therapy on QOL and factors associated with long-term benefit. Design Prospective, open-label trial. Setting Referral center. Patients Twenty patients with hypoparathyoidism. Main Outcome Measures RAND 36-Item Short Form Health Survey (SF-36). Results rhPTH therapy led to substantial improvement in five of the eight SF-36 domains [vitality, social functioning (SF), mental health (MH), bodily pain (BP) and general health] and three of these domains (SF, MH, BP) were no longer lower than the reference population. The improvement in the mental component summary (MCS) score was sustained through 8 years, while the physical component summary (PCS) score improved through 6 years. A lower baseline QOL score was associated with greater improvement. A threshold value <238 (MCS) and <245 (PCS) predicted long-term improvement in 90% and 100% of the cohort, respectively. In patients whose calcium supplementation was reduced, MCS and PCS scores improved more than those whose supplementation did not decline to the same extent. Improvement in PCS was greater in patients whose calcitriol dosage was reduced and duration of disease was shorter. Conclusions rhPTH(1-84) improves long-term well-being in hypoparathyroidism. The improvements are most prominent in those with impaired SF-36 at baseline and those whose requirements for conventional therapy decreased substantially.

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Quality of Life After Thyroidectomy for Hashimoto Disease in Patients With Persistent Symptoms

Ear Nose & Throat Journal ◽

10.1177/0145561320967332 ◽

2020 ◽

pp. 014556132096733

Author(s):

Priyanka Thatipamala ◽

Julia E. Noel ◽

Lisa Orloff

Keyword(s):

Quality Of Life ◽

Antibody Titer ◽

General Health ◽

Short Form ◽

Well Being ◽

Hashimoto Thyroiditis ◽

Thyroid Peroxidase ◽

Persistent Symptoms ◽

Sf 36

Objectives: To determine whether thyroidectomy improves quality of life in patients with Hashimoto thyroiditis with persistent symptoms despite biochemical euthyroidism. Methods: A retrospective cohort study was conducted of patients undergoing thyroidectomy for Hashimoto thyroiditis at our institution between 2014 and 2018. The following variables were collected: age, race, body mass index, preoperative symptoms, preoperative thyroid peroxidase antibody titer, thyroglobulin antibody titer, thyroid-stimulating hormone, free thyroxine, specimen weight, and histologic presence of thyroiditis. Outcomes included general health score on the Short Form 36 (SF-36) Health and responses to a questionnaire addressing postoperative disease management. Results: A total of 19 patients were included in the study, 18 of whom were female with a mean age of 48 years. The majority of patients were Caucasian. There were no significant differences between the postoperative general health scores of the patients with Hashimoto thyroiditis and scores from a healthy control population (66.9 vs 74.1; 95% CI: −16.9 to +2.5, P = .16). There were also no differences between groups within the 7 SF-36 subscores. Elevation in preoperative thyroperoxidase antibody correlated with lower reported postoperative energy levels ( r = −0.63, P = .016) and emotional well-being ( r = −.55, P = .041); 87.5% of respondents reported being moderately or extremely happy with their decision to proceed with surgery. Conclusions: Quality of life in patients with Hashimoto thyroiditis who undergo thyroidectomy is equivalent to the general population, and the majority are satisfied with surgery. Thyroidectomy is a consideration for patients with persistent symptoms despite optimization on medical therapy.

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Assessment of Quality of Life in Patients with Medication-Related Osteonecrosis of the Jaw Following Reconstructive and Restorative Surgery

Applied Sciences ◽

10.3390/app112411950 ◽

2021 ◽

Vol 11 (24) ◽

pp. 11950

Author(s):

Kirill Arturovich Polyakov ◽

Sofia Vladimirovna Popova ◽

Liudmila Sergeevna Shamanaeva ◽

Sergei Yurievich Ivanov ◽

Pavel Sergeevich Petruk ◽

...

Keyword(s):

Quality Of Life ◽

Radical Surgery ◽

Bodily Pain ◽

Main Group ◽

Control Group ◽

Life Questionnaire ◽

Quality Of Life Questionnaire ◽

Sf 36 ◽

The Mean

Recently, numerous articles have been published describing atypical lesions of the jaw bones related to treatment with medications based on phosphorus or analogs of its compounds, particularly bisphosphonates. Goal: To conduct a comparative analysis of the quality of life after radical surgery of the jaw in patients with medication-related osteonecrosis. A total of 82 patients were interviewed, of which 39 (47.6%) patients were in the control group (conservative treatment) and 43 (52.4%) patients in the main group had radical surgical treatment. The mean age of patients in both groups was 66.8 ± 10.03 years. Treatment of patients in the control group in terms of conventional conservative protocol included the local application of 0.05% chlorhexidine solution 1–2 times a day, antibacterial therapy (clindamycin—150 mg 4 times daily for 7 days) and NSAIDs (nimesulide). Patients in the main group (n = 43) underwent segmental resection of the jaw. Thirty days and then 6 months after the treatment, all patients were asked to assess the intensity of pain using a numerical scale, where 0 = no pain, 5 = moderate pain and 10 = the most severe pain imaginable, and to fill in the SF-36 Quality of Life Questionnaire. Results: An analysis of the results obtained with the Numeric Pain Rating Scale demonstrated that the mean pain intensity before treatment was 8.9 points in the control group, and 9.7 in the main group. These values were indicative of “unbearable pain.” After treatment (30 days), the pain score in the control group decreased and amounted to 4.1, which is evidence of the persistence of “moderate pain” in patients. In patients who underwent segmental jaw resection, the mean pain intensity was 0.5. There was no relationship with gender, but there was a direct relationship between the intensity of the pain and the stage of the process (CI = 95%). The SF-36 quality of life questionnaire showed that in the control group, who were treated conservatively, bodily pain (BoP) decreased from a score of 91.2 to 34.3, and the mental health score increased from 34.2 before treatment to 36.3 after treatment, which indicates the persistence of discomfort. The remaining parameters improved after treatment, but no complete recovery was achieved. Before radical surgery, the main group of patients also had a high level of bodily pain (95.2), but after surgery this decreased to 12.4. The remaining parameters also showed a significant difference before and after radical surgery, indicating a positive trend. Radical surgery allows us to improve the quality of life of patients, thereby confirming that surgical volume is a secondary aspect if there is no relapse after the treatment.

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