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Clin Colon Rectal Surg 2024; 37(02): 102-107
DOI: 10.1055/s-0043-1761476
Review Article

Quality of Life Outcomes in Stage IV Colorectal Cancer

Cyrus Ali Feizpour
1   Division of General Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana
,
Anita Turk
2   Division of Hematology/Oncology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
,
Sanjay Mohanty
1   Division of General Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana
› Author Affiliations Funding S.M. received grant: NIH K23AG071945-01A1.
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Abstract

With improvements across the colorectal cancer care continuum, from screening and earlier detection to better systemic options, patients are living longer with the disease. Given these improvements over the last several decades, quality of life outcomes have become important components when evaluating treatment efficacy and adverse effects. This article reviews quality of life measurement generally, discusses tools currently being used in colorectal cancer patients, and reviews outcomes following both surgical and nonsurgical management from clinical trials, observational studies, and meta-analyses.

Keywords

quality of life - colorectal cancer - metastatic


Publication History

Article published online:
08 February 2023

© 2023. Thieme. All rights reserved.

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  • References

  • 1 Cella DF, Tulsky DS. Quality of life in cancer: definition, purpose, and method of measurement. Cancer Invest 1993; 11 (03) 327-336
    CrossrefPubMedGoogle Scholar
  • 2 Roila F, Cortesi E. Quality of life as a primary end point in oncology. Ann Oncol 2001; 12 (suppl (Suppl. 03) S3-S6
    CrossrefPubMedGoogle Scholar
  • 3 Herdman M, Gudex C, Lloyd A. et al. Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res 2011; 20 (10) 1727-1736
    CrossrefPubMedGoogle Scholar
  • 4 Brazier JE, Harper R, Jones NMB. et al. Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ 1992; 305 (6846): 160-164
    CrossrefPubMedGoogle Scholar
  • 5 Cella DF, Tulsky DS, Gray G. et al. The Functional Assessment of Cancer Therapy scale: development and validation of the general measure. J Clin Oncol 1993; 11 (03) 570-579
    CrossrefPubMedGoogle Scholar
  • 6 Sprangers MAG, Cull A, Groenvold M, Bjordal K, Blazeby J, Aaronson NK. EORTC Quality of Life Study Group. The European Organization for Research and Treatment of Cancer approach to developing questionnaire modules: an update and overview. Qual Life Res 1998; 7 (04) 291-300
    CrossrefPubMedGoogle Scholar
  • 7 Ferrell BR, Dow KH, Grant M. Measurement of the quality of life in cancer survivors. Qual Life Res 1995; 4 (06) 523-531
    CrossrefPubMedGoogle Scholar
  • 8 Ward WL, Hahn EA, Mo F, Hernandez L, Tulsky DS, Cella D. Reliability and validity of the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) quality of life instrument. Qual Life Res 1999; 8 (03) 181-195
    CrossrefPubMedGoogle Scholar
  • 9 Sprangers MA, te Velde A, Aaronson NK. European Organization for Research and Treatment of Cancer Study Group on Quality of Life. The construction and testing of the EORTC colorectal cancer-specific quality of life questionnaire module (QLQ-CR38). Eur J Cancer 1999; 35 (02) 238-247
    CrossrefPubMedGoogle Scholar
  • 10 Ganesh V, Agarwal A, Popovic M. et al. Comparison of the FACT-C, EORTC QLQ-CR38, and QLQ-CR29 quality of life questionnaires for patients with colorectal cancer: a literature review. Support Care Cancer 2016; 24 (08) 3661-3668
    CrossrefPubMedGoogle Scholar
  • 11 Emmertsen KJ, Laurberg S. Low anterior resection syndrome score: development and validation of a symptom-based scoring system for bowel dysfunction after low anterior resection for rectal cancer. Ann Surg 2012; 255 (05) 922-928
    CrossrefPubMedGoogle Scholar
  • 12 Grant M, Ferrell B, Dean G, Uman G, Chu D, Krouse R. Revision and psychometric testing of the City of Hope Quality of Life-Ostomy Questionnaire. Qual Life Res 2004; 13 (08) 1445-1457
    CrossrefPubMedGoogle Scholar
  • 13 Lim CYS, Laidsaar-Powell RC, Young JM, Kao SCH, Zhang Y, Butow P. Colorectal cancer survivorship: a systematic review and thematic synthesis of qualitative research. Eur J Cancer Care (Engl) 2021; 30 (04) e13421
    PubMedGoogle Scholar
  • 14 Jaeschke R, Singer J, Guyatt GH. Measurement of health status. Ascertaining the minimal clinically important difference. Control Clin Trials 1989; 10 (04) 407-415
    PubMedGoogle Scholar
  • 15 Ringash J, O'Sullivan B, Bezjak A, Redelmeier DA. Interpreting clinically significant changes in patient-reported outcomes. Cancer 2007; 110 (01) 196-202
    CrossrefPubMedGoogle Scholar
  • 16 Cocks K, King MT, Velikova G, Martyn St-James M, Fayers PM, Brown JM. Evidence-based guidelines for determination of sample size and interpretation of the European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30. J Clin Oncol 2011; 29 (01) 89-96
    CrossrefPubMedGoogle Scholar
  • 17 Gao X, Kahl AR, Goffredo P. et al. Treatment of stage IV colon cancer in the United States: a patterns-of-care analysis. J Natl Compr Canc Netw 2020; 18 (06) 689-699
    CrossrefPubMedGoogle Scholar
  • 18 Eyl RE, Xie K, Koch-Gallenkamp L, Brenner H, Arndt V. Quality of life and physical activity in long-term (≥5 years post-diagnosis) colorectal cancer survivors - systematic review. Health Qual Life Outcomes 2018; 16 (01) 112
    CrossrefPubMedGoogle Scholar
  • 19 Firkins J, Hansen L, Driessnack M, Dieckmann N. Quality of life in “chronic” cancer survivors: a meta-analysis. J Cancer Surviv 2020; 14 (04) 504-517
    CrossrefPubMedGoogle Scholar
  • 20 Adams SV, Ceballos R, Newcomb PA. Quality of life and mortality of long-term colorectal cancer survivors in the Seattle Colorectal Cancer Family Registry. PLoS One 2016; 11 (06) e0156534
    CrossrefPubMedGoogle Scholar
  • 21 Quinten C, Martinelli F, Coens C. et al; Patient Reported Outcomes and Behavioral Evidence (PROBE) and the European Organization for Research and Treatment of Cancer (EORTC) Clinical Groups. A global analysis of multitrial data investigating quality of life and symptoms as prognostic factors for survival in different tumor sites. Cancer 2014; 120 (02) 302-311
    CrossrefPubMedGoogle Scholar
  • 22 Bonnetain F, Borg C, Adams RR. et al. How health-related quality of life assessment should be used in advanced colorectal cancer clinical trials. Ann Oncol 2017; 28 (09) 2077-2085
    CrossrefPubMedGoogle Scholar
  • 23 Efficace F, Bottomley A, Coens C. et al. Does a patient's self-reported health-related quality of life predict survival beyond key biomedical data in advanced colorectal cancer?. Eur J Cancer 2006; 42 (01) 42-49
    CrossrefPubMedGoogle Scholar
  • 24 Earlam S, Glover C, Fordy C, Burke D, Allen-Mersh TG. Relation between tumor size, quality of life, and survival in patients with colorectal liver metastases. J Clin Oncol 1996; 14 (01) 171-175
    CrossrefPubMedGoogle Scholar
  • 25 de Kort SJ, Willemse PHB, Habraken JM, de Haes HCJM, Willems DL, Richel DJ. Quality of life versus prolongation of life in patients treated with chemotherapy in advanced colorectal cancer: a review of randomized controlled clinical trials. Eur J Cancer 2006; 42 (07) 835-845
    CrossrefPubMedGoogle Scholar
  • 26 Ringash J, Au HJ, Siu LL. et al; NCIC Clinical Trials Group; Australasian Gastrointestinal Trials Group. Quality of life in patients with K-RAS wild-type colorectal cancer: the CO.20 phase 3 randomized trial. Cancer 2014; 120 (02) 181-189
    CrossrefPubMedGoogle Scholar
  • 27 Seymour MT, Thompson LC, Wasan HS. et al; FOCUS2 Investigators; National Cancer Research Institute Colorectal Cancer Clinical Studies Group. Chemotherapy options in elderly and frail patients with metastatic colorectal cancer (MRC FOCUS2): an open-label, randomised factorial trial. Lancet 2011; 377 9779 1749-1759
    CrossrefPubMedGoogle Scholar
  • 28 D'Amico TA, Bandini LAM, Balch A. et al. Quality measurement in cancer care: a review and endorsement of high-impact measures and concepts. J Natl Compr Canc Netw 2020; 18 (03) 250-259
    CrossrefPubMedGoogle Scholar
  • 29 Andre T, Amonkar M, Norquist JM. et al. Health-related quality of life in patients with microsatellite instability-high or mismatch repair deficient metastatic colorectal cancer treated with first-line pembrolizumab versus chemotherapy (KEYNOTE-177): an open-label, randomised, phase 3 trial. Lancet Oncol 2021; 22 (05) 665-677
    CrossrefPubMedGoogle Scholar
  • 30 Yoshino T, Watanabe J, Shitara K. et al. Panitumumab (PAN) plus mFOLFOX6 versus bevacizumab (BEV) plus mFOLFOX6 as first-line treatment in patients with RAS wild-type (WT) metastatic colorectal cancer (mCRC): Results from the phase 3 PARADIGM trial. J Clin Oncol 2022; 40 (17) , suppl); LBA1-LBA1
    CrossrefPubMedGoogle Scholar
  • 31 Avallone A, Giuliani F, Nasti G. et al. Randomized intermittent or continuous panitumumab plus FOLFIRI (FOLFIRI/PANI) for first-line treatment of patients (pts) with RAS/BRAF wild-type (wt) metastatic colorectal cancer (mCRC): The IMPROVE study. J Clin Oncol 2022; 40 (16) , suppl): 3503-3503
    CrossrefPubMedGoogle Scholar
  • 32 Rausa E, Kelly ME, Bonavina L, O'Connell PR, Winter DC. A systematic review examining quality of life following pelvic exenteration for locally advanced and recurrent rectal cancer. Colorectal Dis 2017; 19 (05) 430-436
    CrossrefPubMedGoogle Scholar
  • 33 Quyn AJ, Solomon MJ, Lee PM, Badgery-Parker T, Masya LM, Young JM. Palliative pelvic exenteration: clinical outcomes and quality of life. Dis Colon Rectum 2016; 59 (11) 1005-1010
    CrossrefPubMedGoogle Scholar
  • 34 Wei AC, Coburn NG, Devitt KS. et al. Survival following resection of intra- and extra-hepatic metastases from colorectal cancer: a phase II trial. Ann Surg Oncol 2016; 23 (08) 2644-2651
    CrossrefPubMedGoogle Scholar
  • 35 Wanis KN, Ardiles V, Alvarez FA. et al. Intermediate-term survival and quality of life outcomes in patients with advanced colorectal liver metastases undergoing associating liver partition and portal vein ligation for staged hepatectomy. Surgery 2018; 163 (04) 691-697
    CrossrefPubMedGoogle Scholar
  • 36 Heise D, Bayings W, Tuinhof A. et al. Long-term outcome and quality of life after initial and repeat resection of colorectal liver metastasis: a retrospective analysis. Int J Surg 2017; 48 (November): 281-285
    CrossrefPubMedGoogle Scholar
  • 37 Seretis C, Youssef H. Quality of life after cytoreductive surgery and intraoperative hyperthermic intraperitoneal chemotherapy for peritoneal surface malignancies: a systematic review. Eur J Surg Oncol 2014; 40 (12) 1605-1613
    CrossrefPubMedGoogle Scholar
  • 38 Juul T, Ahlberg M, Biondo S. et al. International validation of the low anterior resection syndrome score. Ann Surg 2014; 259 (04) 728-734
    CrossrefPubMedGoogle Scholar
  • 39 Pachler J, Wille-Jørgensen P. Quality of life after rectal resection for cancer, with or without permanent colostomy. Cochrane Database Syst Rev 2012; 12: CD004323
    PubMedGoogle Scholar
  • 40 Maguire B, Clancy C, Connelly TM. et al. Quality of life meta-analysis following coloanal anastomosis versus abdominoperineal resection for low rectal cancer. Colorectal Dis 2022; 24 (07) 811-820
    CrossrefPubMedGoogle Scholar