Health-related quality of life and oncologic outcomes after surgery in older adults with colorectal cancer

Blakely, Andrew M.; Chanson, Dayana; Wong, F. Lennie; Eng, Oliver S.; Sentovich, Stephen M.; Melstrom, Kurt; Lai, Lily; Fong, Yuman; Sun, Virginia

doi:10.1007/s00520-019-05087-3

Cited by 6 publications

(3 citation statements)

References 34 publications

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“…At 1 year postoperatively for 590 older adult cancer patients in a Surveillance, Epidemiology, and End Results (SEER)/Medicare Health Outcomes Survey, 17% of patients had increased dependence for ADLs and 54% had lower physical health-related quality of life. 43 Among older adults ≥ 65 years of age who underwent colorectal surgery, nearly 25% experienced functional decline (increased dependence for ADLs or IADLs) at approximately 1 year postoperatively, compared with nearly 15% for matched nonsurgical controls. 44 The rate of functional decline was even higher after postoperative complications, at 33%.…”

Section: Physical Functionmentioning

confidence: 99%

Navigating the Surgical Pathway for Frail, Older Adults Undergoing Colorectal Surgery

Roo,

Ivatury

2024

Clin Colon Rectal Surg

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Adults ≥ 65 years of age comprise nearly 20% of the U.S. population and over half of surgical patients. Older adults, particularly when frail, may require additional preoperative evaluation and counseling, specialized hospital care, and may experience more noticeable physical and cognitive changes than younger or healthier patients. Surgeons can assess frailty and risk using several frailty measures, as data exist demonstrating worse perioperative outcomes among patients undergoing colorectal surgery. Prehabilitation programs have not been shown to improve surgical outcomes for colorectal surgery patients but may help maintain physical function or hasten recovery to baseline around the time of surgery, particularly for frail patients. Functional decline and delirium are common postoperatively in older adult patients, particularly those who are frail at baseline, and should be discussed with at-risk older adults. Primary care physicians and geriatricians can help with in-depth evaluation of frailty and geriatric syndromes. Special attention to the risks, outcomes, and care of older adults considering or undergoing colorectal surgery can help inform decision-making, which may facilitate goal-concordant care.

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Section: Physical Functionmentioning

confidence: 99%

Navigating the Surgical Pathway for Frail, Older Adults Undergoing Colorectal Surgery

Roo,

Ivatury

2024

Clin Colon Rectal Surg

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“…The evaluation of health-related quality of life (HRQOL) in colorectal cancer (CRC) survivors allows for a better understanding of the patient’s experience of the disease, treatment, and recovery journey aside from just oncological outcomes, which have improved considerably over the decades [ 1 , 2 ]. More importantly, it provides insight into risk factors for low postoperative HRQOL, which can guide the implementation of appropriate interventions and survivorship care plans to minimize the impact on future patients [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Preoperative Quality of Life and Mental Health Can Predict Postoperative Outcomes and Quality of Life after Colorectal Cancer Surgery

et al. 2023

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Background and Objectives: It remains unclear which domains of preoperative health-related quality of life (HRQOL) and mental health are predictive of postoperative clinical and patient-reported outcomes in colorectal cancer (CRC) patients. Materials and Methods: A prospective cohort of 78 CRC patients undergoing elective curative surgery was recruited. The EORTC QLQ-C30 and HADS questionnaires were administered preoperatively and one month after surgery. Results: Preoperative cognitive functioning scores (95% CI 0.131–1.158, p = 0.015) and low anterior resection (95% CI 14.861–63.260, p = 0.002) independently predicted poorer 1-month postoperative global QOL. When postoperative complications were represented using the comprehensive complication index (CCI), poorer preoperative physical function scores were associated with higher CCI scores (B = −0.277, p = 0.014). Preoperative social function score (OR = 0.925, 95% CI 0.87 to 0.99; p = 0.019) was an independent predictor for 30-day readmission, while physical functioning score (OR = −0.620, 95% CI −1.073–−0.167, p = 0.008) was inversely related to the length of hospitalization. The overall regressions for 1-month postoperative global QOL (R2: 0.546, F: 1.961, p = 0.023) and 30-day readmission (R2: 0.322, χ2: 13.129, p < 0.001) were statistically significant. Conclusions: Various QLQ-C30 domains were found to be predictive of postoperative outcomes, including complications, readmission, and length of hospitalization. Preoperative cognitive dysfunction and low AR were independent predictors of poorer postoperative global QOL. Future research should seek to examine the efficacy of targeting specific baseline QOL domains in improving clinical as well as patient-reported outcomes after CRC surgery.

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“…[8][9][10] Although age has been identified as a significant correlate of HRQOL in survivors of CRC, 9,11,12 this key outcome has been underexplored among older adult survivors of CRC. 7,13 For example, Blakely and colleagues 14 found a significant decrease in both physical and mental HRQOL scores in most older adult survivors of CRC at a median of 25 months after surgery. However, it is unclear whether poorer HRQOL persists among longer-term survivors of CRC or whether older age at diagnosis is a risk for poorer HRQOL.…”

mentioning

confidence: 99%

Correlates of Health-Related Quality of Life in a National Sample of Older Adult, Long-Term Survivors of Colorectal Cancer

Burrell

Sasso²,

Greenle³

2023

Cancer Nurs

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Background: Most survivors of colorectal cancer (CRC) are older adults who are at high risk of experiencing adverse effects and decreased health-related quality of life (HRQOL) related to cancer and its treatments. Objective: This study aimed to describe HRQOL and the demographic and clinical factors associated with HRQOL among older adult, long-term survivors of CRC. Methods: A sample of older adult, long-term survivors of CRC (N = 14458) from the Surveillance Epidemiology and End Results-Medicare Health Outcomes Survey dataset was selected. Hierarchical multiple regression was used to analyze the contribution of demographic and clinical variables to HRQOL as measured by the Veterans Rand 12-item scale. Results: The mean respondent age was 79 years with an average time from diagnosis to survey being about 13 years. In the final model, gender, race, education, income, previous radiation treatment, cardiovascular disease, inflammatory bowel disease, depression, pain, fatigue, functional status, and generalhealth perception were all significantly correlated with mental HRQOL (R 2 = 0.53). For physical HRQOL, age at diagnosis, race, marital status, education, time since diagnosis, comorbid conditions, depression, pain, fatigue, functional status, and general health perception were all significant correlates (R 2 = 0.85). Symptoms were the largest contributors to mental and physical HRQOL, accounting for 43% and 50% of the variance, respectively. Conclusion: Pain, depression, and fatigue significantly affect the HRQOL of older adult survivors of CRC, underscoring the need for long-term survivorship care.

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Health-related quality of life and oncologic outcomes after surgery in older adults with colorectal cancer

Cited by 6 publications

References 34 publications

Navigating the Surgical Pathway for Frail, Older Adults Undergoing Colorectal Surgery

Navigating the Surgical Pathway for Frail, Older Adults Undergoing Colorectal Surgery

Preoperative Quality of Life and Mental Health Can Predict Postoperative Outcomes and Quality of Life after Colorectal Cancer Surgery

Correlates of Health-Related Quality of Life in a National Sample of Older Adult, Long-Term Survivors of Colorectal Cancer

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