Health-related quality of life after laparoscopic and open surgery for rectal cancer in a randomized trial

Andersson, John; Gellerstedt, Martin; Angerås, Ulf; Jess, P.; Rosenberg, Jacob; Fürst, Alois; Bonjer, Jaap; Haglind, Eva

doi:10.1002/bjs.9144

Cited by 86 publications

(44 citation statements)

References 21 publications

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“…Those data are not commonly reported. Several studies assessed in-hospital recovery [3], return to work [31], or assessed physical functioning only after surgery [9, 10, 32, 33]. We found that 54% of CRC patients had not recovered their pre-surgery physical functioning at 6-months post-diagnosis.…”

Section: Discussionmentioning

confidence: 86%

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An increase in physical activity after colorectal cancer surgery is associated with improved recovery of physical functioning: a prospective cohort study

et al. 2017

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BackgroundThe influence of physical activity on patient-reported recovery of physical functioning after colorectal cancer (CRC) surgery is unknown. Therefore, we studied recovery of physical functioning after hospital discharge by (a) a relative increase in physical activity level and (b) absolute activity levels before and after surgery.MethodsWe included 327 incident CRC patients (stages I–III) from a prospective observational study. Patients completed questionnaires that assessed physical functioning and moderate-to-vigorous physical activity shortly after diagnosis and 6 months later. Cox regression models were used to calculate prevalence ratios (PRs) of no recovery of physical functioning. All PRs were adjusted for age, sex, physical functioning before surgery, stage of disease, ostomy and body mass index.ResultsAt 6 months post-diagnosis 54% of CRC patients had not recovered to pre-operative physical functioning. Patients who increased their activity by at least 60 min/week were 43% more likely to recover physical function (adjusted PR 0.57 95%CI 0.39–0.82), compared with those with stable activity levels. Higher post-surgery levels of physical activity were also positively associated with recovery (P for trend = 0.01). In contrast, activity level before surgery was not associated with recovery (P for trend = 0.24).ConclusionsAt 6 month post-diagnosis, about half of CRC patients had not recovered to preoperative functioning. An increase in moderate-to-vigorous physical activity after CRC surgery was associated with enhanced recovery of physical functioning. This benefit was seen regardless of physical activity level before surgery. These associations provide evidence to further explore connections between physical activity and recovery from CRC surgery after discharge from the hospital.

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Section: Discussionmentioning

confidence: 86%

“…Low physical functioning is associated with disability and a loss of independence [8]. Following a rapid decline after CRC surgery [1, 9, 10], patient physical function scores return to pre-operative values [9, 10]. However, not all individual CRC patients recover to their pre-operative level of physical functioning.…”

Section: Introductionmentioning

confidence: 99%

An increase in physical activity after colorectal cancer surgery is associated with improved recovery of physical functioning: a prospective cohort study

et al. 2017

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“…There are numerous studies correlating objective outcome measures with patient-centered outcomes in cancer patients. 9–11 This work suggests a negative correlation between higher patients' quality of life and the incidence of postoperative complications. Beyond the surgical literature, evidence from a large statewide demonstration suggests that patients' perspectives of care can incentivize providers to improve quality in the primary care setting.…”

Section: Introductionmentioning

confidence: 79%

Patients' Perspectives of Care and Surgical Outcomes in Michigan

et al. 2014

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Objective To determine the relationship between postoperative morbidity and mortality and patients' perspectives of care. Summary Background Data Priorities in healthcare quality research are shifting to place greater emphasis on patient-centered outcomes. Whether patients' perspectives of care correlate with surgical outcomes remains unclear. Methods Using data from the Michigan Surgical Quality Collaborative clinical registry (2008–2012), we identified 41,833 patients undergoing major elective general or vascular surgery. Our exposure variables were the HCAHPS Total and Base Scores derived from the Hospital Value-Based Purchasing (VBP) Patient Experience of Care Domain. Using multilevel mixed-effects logistic regression models, we adjusted hospitals' rates of morbidity and mortality for patient comorbidities and case mix. We stratified reporting of outcomes by quintiles of hospitals' Total and Base Scores. Results Risk-adjusted morbidity (13.6% to 28.6%) varied widely across hospitals. There were no significant differences in risk-adjusted morbidity rates between hospitals with the lowest versus highest HCAHPS Total Score (24.5% vs. 20.2%, p=0.312). The HCAHPS Base Score, which quantifies sustained achievement or improvement in patients' perspectives of care, was not associated with a reduction in postoperative morbidity over the study period despite an overall decrease of 2.5% for all centers. We observed a similar relationship between HCAHPS Total and Base Scores and postoperative mortality. Conclusions and Relevance Patients' perspectives of care do not correlate with the incidence of morbidity and mortality following major surgery. Improving patients' perspectives and objective outcomes may require separate initiatives for surgeons in Michigan.

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“…Some studies did not report their settings or were multinational or multicentre studies [55–60]. Studies were mostly published in the last 15–20 years and focussed narrowly on different interventions at specific stages of CRC.…”

Section: Resultsmentioning

confidence: 99%

Systematic review of health state utility values for economic evaluation of colorectal cancer

Kim

Cairns

2016

Health Econ Rev

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Cost-utility analyses undertaken to inform decision making regarding colorectal cancer (CRC) require a set of health state utility values (HSUVs) so that the time CRC patients spend in different health states can be aggregated into quality-adjusted life-years (QALY). This study reviews CRC-related HSUVs that could be used in economic evaluation and assesses their advantages and disadvantages with respect to valuation methods used and CRC clinical pathways. Fifty-seven potentially relevant studies were identified which collectively report 321 CRC-related HSUVs. HSUVs (even for similar health states) vary markedly and this adds to the uncertainty regarding estimates of cost-effectiveness. There are relatively few methodologically robust HSUVs that can be directly used in economic evaluations concerned with CRC. There is considerable scope to develop new HSUVs which improve on those currently available either by expanded collection of generic measures or by making greater use of condition-specific data, for example, using mapping algorithms.Electronic supplementary materialThe online version of this article (doi:10.1186/s13561-016-0115-5) contains supplementary material, which is available to authorized users.

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Health-related quality of life after laparoscopic and open surgery for rectal cancer in a randomized trial

Cited by 86 publications

References 21 publications

An increase in physical activity after colorectal cancer surgery is associated with improved recovery of physical functioning: a prospective cohort study

An increase in physical activity after colorectal cancer surgery is associated with improved recovery of physical functioning: a prospective cohort study

Patients' Perspectives of Care and Surgical Outcomes in Michigan

Systematic review of health state utility values for economic evaluation of colorectal cancer

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