Surviving rectal cancer at the cost of a colostomy: global survey of long-term health-related quality of life in 10 countries.


Journal

BJS open
ISSN: 2474-9842
Titre abrégé: BJS Open
Pays: England
ID NLM: 101722685

Informations de publication

Date de publication:
02 11 2022
Historique:
received: 23 12 2021
revised: 22 04 2022
accepted: 20 05 2022
entrez: 22 12 2022
pubmed: 23 12 2022
medline: 24 12 2022
Statut: ppublish

Résumé

Colorectal cancer management may require an ostomy formation; however, a stoma may negatively impact health-related quality of life (HRQoL). This study aimed to compare generic and stoma-specific HRQoL in patients with a permanent colostomy after rectal cancer across different countries. A cross-sectional cohorts of patients with a colostomy after rectal cancer in Denmark, Sweden, Spain, the Netherlands, China, Portugal, Australia, Lithuania, Egypt, and Israel were invited to complete questionnaires regarding demographic and socioeconomic factors along with the Colostomy Impact (CI) score, European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30) and five anchor questions assessing colostomy impact on HRQoL. The background characteristics of the cohorts from each country were compared and generic HRQoL was measured with the EORTC QLQ-C30 presented for the total cohort. Results were compared with normative data of reference European populations. The predictors of reduced HRQoL were investigated by multivariable logistic regression, including demographic and socioeconomic factors and stoma-related problems. A total of 2557 patients were included. Response rates varied between 51-93 per cent. Mean time from stoma creation was 2.5-6.2 (range 1.1-39.2) years. A total of 25.8 per cent of patients reported that their colostomy impairs their HRQoL 'some'/'a lot'. This group had significantly unfavourable scores across all EORTC subscales compared with patients reporting 'no'/'a little' impaired HRQoL. Generic HRQoL differed significantly between countries, but resembled the HRQoL of reference populations. Multivariable logistic regression showed that stoma dysfunction, including high CI score (OR 3.32), financial burden from the stoma (OR 1.98), unemployment (OR 2.74), being single/widowed (OR 1.35) and young age (OR 1.01 per year) predicted reduced stoma-related HRQoL. Overall HRQoL is preserved in patients with a colostomy after rectal cancer, but a quarter of the patients interviewed reported impaired HRQoL. Differences among several countries were reported and socioeconomic factors correlated with reduced quality of life.

Sections du résumé

BACKGROUND
Colorectal cancer management may require an ostomy formation; however, a stoma may negatively impact health-related quality of life (HRQoL). This study aimed to compare generic and stoma-specific HRQoL in patients with a permanent colostomy after rectal cancer across different countries.
METHOD
A cross-sectional cohorts of patients with a colostomy after rectal cancer in Denmark, Sweden, Spain, the Netherlands, China, Portugal, Australia, Lithuania, Egypt, and Israel were invited to complete questionnaires regarding demographic and socioeconomic factors along with the Colostomy Impact (CI) score, European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30) and five anchor questions assessing colostomy impact on HRQoL. The background characteristics of the cohorts from each country were compared and generic HRQoL was measured with the EORTC QLQ-C30 presented for the total cohort. Results were compared with normative data of reference European populations. The predictors of reduced HRQoL were investigated by multivariable logistic regression, including demographic and socioeconomic factors and stoma-related problems.
RESULTS
A total of 2557 patients were included. Response rates varied between 51-93 per cent. Mean time from stoma creation was 2.5-6.2 (range 1.1-39.2) years. A total of 25.8 per cent of patients reported that their colostomy impairs their HRQoL 'some'/'a lot'. This group had significantly unfavourable scores across all EORTC subscales compared with patients reporting 'no'/'a little' impaired HRQoL. Generic HRQoL differed significantly between countries, but resembled the HRQoL of reference populations. Multivariable logistic regression showed that stoma dysfunction, including high CI score (OR 3.32), financial burden from the stoma (OR 1.98), unemployment (OR 2.74), being single/widowed (OR 1.35) and young age (OR 1.01 per year) predicted reduced stoma-related HRQoL.
CONCLUSION
Overall HRQoL is preserved in patients with a colostomy after rectal cancer, but a quarter of the patients interviewed reported impaired HRQoL. Differences among several countries were reported and socioeconomic factors correlated with reduced quality of life.

Identifiants

pubmed: 36546340
pii: 6955596
doi: 10.1093/bjsopen/zrac085
pmc: PMC9772877
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Aarhus University Hospital
Organisme : Bengt Ihre Foundation

Commentaires et corrections

Type : CommentIn

Informations de copyright

© The Author(s) 2022. Published by Oxford University Press on behalf of BJS Society Ltd.

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Auteurs

Helle Ø Kristensen (HØ)

Department of Surgery, Aarhus University Hospital, Aarhus, Denmark.
Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects After Cancer in the Pelvic Organs, Aarhus, Denmark.

Anne Thyø (A)

Department of Surgery, Aarhus University Hospital, Aarhus, Denmark.
Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects After Cancer in the Pelvic Organs, Aarhus, Denmark.
Surgical Department, Randers Regional Hospital, Randers, Denmark.

Katrine J Emmertsen (KJ)

Department of Surgery, Aarhus University Hospital, Aarhus, Denmark.
Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects After Cancer in the Pelvic Organs, Aarhus, Denmark.
Surgical Department, Randers Regional Hospital, Randers, Denmark.

Neil J Smart (NJ)

Royal Devon and Exeter NHS Foundation Trust, Royal Devon and Exeter Hospital, Exeter, UK.

Thomas Pinkney (T)

University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.

Andrea M Warwick (AM)

Brisbane Academic Functional Colorectal Unit, QEII Hospital, Brisbane, Queensland, Australia.

Dong Pang (D)

Peking University School of Nursing, Peking, China.

Hossam Elfeki (H)

Colorectal Surgery Unit, Mansoura University Hospital, Mansoura, Egypt.

Mostafa Shalaby (M)

Colorectal Surgery Unit, Mansoura University Hospital, Mansoura, Egypt.

Sameh H Emile (SH)

Colorectal Surgery Unit, Mansoura University Hospital, Mansoura, Egypt.

Mohamed Abdelkhalek (M)

Surgical Oncology Department, Oncology Center Mansoura University (OCMU), Mansoura, Egypt.

Mohammad Zuhdy (M)

Surgical Oncology Department, Oncology Center Mansoura University (OCMU), Mansoura, Egypt.

Tomas Poskus (T)

Department of Abdominal and General Surgery and Oncology, Faculty of Medicine, Vilnius University, National Cancer Institute, Vilnius, Lithuania.

Audrius Dulskas (A)

Department of Abdominal and General Surgery and Oncology, Faculty of Medicine, Vilnius University, National Cancer Institute, Vilnius, Lithuania.

Nir Horesh (N)

Sheba Medical Center, Ramat Gan, Israel.

Edgar J B Furnée (EJB)

Department of Surgery, Division of Abdominal Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Sanne J Verkuijl (SJ)

Department of Surgery, Division of Abdominal Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Nuno José Rama (NJ)

Surgery Colorectal Unit, Centro Hospitalar de Leiria, Leiria, Portugal.

Hugo Domingos (H)

Colorectal Surgery Unit, Champalimaud Foundation, Lisbon, Portugal.

João Maciel (J)

Colorectal Surgery Unit, Instituto Português de Oncologia, Lisbon, Portugal.

Alejandro Solis-Peña (A)

Colorectal Surgery Unit, General Surgery Department, Universitat Autonoma de Barcelona, Hospital Vall d'Hebron, Barcelona, Spain.

Eloy Espín-Basany (E)

Colorectal Surgery Unit, General Surgery Department, Universitat Autonoma de Barcelona, Hospital Vall d'Hebron, Barcelona, Spain.

Marta Hidalgo-Pujol (M)

Department of General and Digestive Surgery, Colorectal Unit, Bellvitge University Hospital, University of Barcelona and IDIBELL, Barcelona, Spain.

Sebastiano Biondo (S)

Department of General and Digestive Surgery, Colorectal Unit, Bellvitge University Hospital, University of Barcelona and IDIBELL, Barcelona, Spain.

Annika Sjövall (A)

Division of Coloproctology, Department of Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden.
Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockhom, Sweden.

Peter Christensen (P)

Department of Surgery, Aarhus University Hospital, Aarhus, Denmark.

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