Health-Related Quality of Life in Metastatic Colorectal Cancer Patients Treated with Curative Resection and/or Local Ablative Therapy or Systemic Therapy in the Finnish RAXO-Study.
Kaisa LehtomäkiHanna P StedtEmerik OsterlundTimo MuhonenLeena-Maija SoveriPäivi HalonenTapio K SalminenJuha KononenRaija KallioAnnika ÅlgarsEetu HeerväAnnamarja LamminmäkiAki UutelaArno NordinJuho T LehtoTiina SaartoHarri SintonenPirkko-Liisa Kellokumpu-LehtinenRaija RistamäkiBengt GlimeliusHelena IsoniemiPia J OsterlundPublished in: Cancers (2022)
Metastasectomy and/or local ablative therapy in metastatic colorectal cancer (mCRC) patients often provide long-term survival. Health-related quality of life (HRQoL) data in curatively treated mCRC are limited. In the RAXO-study that evaluated repeated resectability, a multi-cross-sectional HRQoL substudy with 15D, EQ-5D-3L, QLQ-C30, and QLQ-CR29 questionnaires was conducted. Mean values of patients in different treatment groups were compared with age- and gender-standardized general Finnish populations. The questionnaire completion rate was 444/477 patients (93%, 1751 questionnaires). Mean HRQoL was 0.89-0.91 with the 15D, 0.85-0.87 with the EQ-5D, 68-80 with the EQ-5D-VAS, and 68-79 for global health status during curative treatment phases, with improvements in the remission phase (disease-free >18 months). In the remission phase, mean EQ-5D and 15D scores were similar to the general population. HRQoL remained stable during first- to later-line treatments, when the aim was no longer cure, and declined notably when tumour-controlling therapy was no longer meaningful. The symptom burden affecting mCRC survivors' well-being included insomnia, impotence, urinary frequency, and fatigue. Symptom burden was lower after treatment and slightly higher, though stable, through all phases of systemic therapy. HRQoL was high in curative treatment phases, further emphasizing the strategy of metastasectomy in mCRC when clinically meaningful.
Keyphrases
- end stage renal disease
- newly diagnosed
- prognostic factors
- ejection fraction
- cross sectional
- metastatic colorectal cancer
- peritoneal dialysis
- rheumatoid arthritis
- stem cells
- systemic lupus erythematosus
- patient reported
- patient reported outcomes
- rectal cancer
- mental health
- depressive symptoms
- young adults
- risk factors
- electronic health record
- machine learning
- disease activity
- deep learning
- mesenchymal stem cells
- genetic diversity