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
| Autor: | Kaisa Lehtomäki, Hanna P. Stedt, Emerik Osterlund, Timo Muhonen, Leena-Maija Soveri, Päivi Halonen, Tapio K. Salminen, Juha Kononen, Raija Kallio, Annika Ålgars, Eetu Heervä, Annamarja Lamminmäki, Aki Uutela, Arno Nordin, Juho Lehto, Tiina Saarto, Harri Sintonen, Pirkko-Liisa Kellokumpu-Lehtinen, Raija Ristamäki, Bengt Glimelius, Helena Isoniemi, Pia Osterlund |
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| Přispěvatelé: | HUS Comprehensive Cancer Center, Department of Oncology, IV kirurgian klinikka, HUS Abdominal Center, Department of Surgery, University of Helsinki, Clinicum, Harri Sintonen Research Group, Department of Public Health, Tampere University, Clinical Medicine |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Cancer Research
Cancer och onkologi INSTRUMENT metastatic colorectal cancer PHASE QLQ-C30 LONG-TERM SURVIVORS 3122 Cancers EQ-5D QLQ-CR29 CHEMOTHERAPY chemotherapy EUROQOL 3142 Public health care science environmental and occupational health humanities systemic therapy LIVER METASTASES health-related quality of life metastasectomy local ablative therapy 15D Oncology Cancer and Oncology 1ST-LINE |
| Zdroj: | Cancers; Volume 14; Issue 7; Pages: 1713 |
| Popis: | Simple Summary Metastatic colorectal cancer is the second most common cause of cancer death. Long-term survival and cure can be achieved after intensive treatments, including metastasectomy, i.e., the removal of all metastases. We wanted to clarify whether a patient health-related quality of life (HRQoL) was reduced by treatments that aimed to maximise metastasectomy rates, and whether HRQoL of treated patients is comparable to the general population. In a cross-sectional study of 444 patients (1751 questionnaires) in the RAXO-study population, we show that HRQoL of intensively treated patients, sometimes with multiple and multisite metastasectomies-usually combined with systemic therapy-remains at a high level during and after curative treatment and when compared with the general population. Good HRQoL was also seen during non-curative treatment from first- to later-lines, with an impaired HRQoL only at end-of-life. Thus, we should aim at maximising metastasectomies since they give long-term survival and sometimes cure with a high HRQoL. 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. |
| Databáze: | OpenAIRE |
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