Health-related quality of life in long-term survivors of colorectal cancer and its association with all-cause mortality: a German cohort study.

TitelHealth-related quality of life in long-term survivors of colorectal cancer and its association with all-cause mortality: a German cohort study.
MedientypJournal Article
Jahr der Veröffentlichung2018
AutorenRatjen I, Schafmayer C, Enderle J, di Giuseppe R, Waniek S, Koch M, Burmeister G, Nöthlings U, Hampe J, Schlesinger S, Lieb W
JournalBMC Cancer
Datum der Veröffentlichung2018 Nov 22
SchlüsselwörterAged, Aged, 80 and over, Cancer Survivors, Cause of Death, Cohort Studies, Colorectal Neoplasms, Cross-Sectional Studies, Female, Germany, Humans, Life Style, Male, Middle Aged, Mortality, Quality of Life, Socioeconomic Factors, Survivors

<p><b>BACKGROUND: </b>The group of colorectal cancer (CRC) survivors continues to grow worldwide. Understanding health-related quality of life (HRQOL) determinants and consequences of HRQOL impairments in long-term CRC survivors may help to individualize survivorship care plans. We aimed to i) examine the HRQOL status of CRC long-term survivors, ii) identify cross-sectional sociodemographic and clinical correlates of HRQOL, and iii) investigate the prospective association of HRQOL after CRC diagnosis with all-cause mortality.</p><p><b>METHODS: </b>We assessed HRQOL within a Northern German cohort of 1294 CRC survivors at a median of 6 years after CRC diagnosis using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). Cross-sectional correlates of different HRQOL dimensions were analyzed using multivariable-adjusted logistic regression models with HRQOL as a binary variable. With multivariable-adjusted Cox proportional hazards regression models, hazard ratios (HR) of all-cause mortality were estimated per 10-point-increments of an HRQOL summary score, a global quality of life scale, and HRQOL functioning and symptom domains.</p><p><b>RESULTS: </b>The median HRQOL summary score was 87 (interquartile range: 75-94). Sex, age, education, tumor location, metastases, other cancers, type of therapy, and current stoma were identified as correlates of different HRQOL scales. After a median follow-up time of 7 years after HRQOL assessment, 175 participants had died. Nearly all HRQOL domains, except for cognitive functioning and diarrhea, were significantly associated with all-cause mortality. A 10-point-increment in the summary score decreased the risk of death by 24% (HR: 0.76; 95% CI: 0.70-0.82).</p><p><b>CONCLUSIONS: </b>HRQOL in CRC survivors appeared to be relatively high in the long term. Various clinical and sociodemographic factors were cross-sectionally associated with HRQOL in long-term CRC survivors. Lower HRQOL was associated with increased all-cause mortality. Individualized healthcare programs for CRC survivors (including psychosocial screening and interventions) are needed to detect decreased HRQOL and to further improve long-term HRQOL and survival.</p>

Alternate JournalBMC Cancer
PubMed ID30466408
PubMed Central IDPMC6251222
Grant ListEXC306 and EXC306/2 / / Deutsche Forschungsgemeinschaft /