Quality of life and fear of cancer recurrence in T1 colorectal cancer patients treated with endoscopic or surgical tumor resection
Dang, Hao; de Vos Tot Nederveen Cappel, Wouter H; van der Zwaan, Sarita M S; van den Akker-van Marle, M Elske; van Westreenen, Henderik L; Backes, Yara; Moons, Leon M G; Holman, Fabian A; Peeters, Koen C M J; van der Kraan, Jolein; Langers, Alexandra M J; Lijfering, Willem M; Hardwick, James C H; Boonstra, Jurjen J
(2019) Gastrointestinal Endoscopy, volume 89, issue 3, pp. 533 - 544
(Article)
Abstract
BACKGROUND AND AIMS: To optimize therapeutic decision-making in early invasive colorectal cancer (T1 CRC) patients, it is important to elicit the patient's perspective next to considering medical outcome. Because empirical data on patient-reported impact of different treatment options are lacking, we evaluated patients' quality of life, perceived time to recovery,
... read more
and fear of cancer recurrence after endoscopic or surgical treatment for T1 CRC. METHODS: In this cross-sectional study, we selected patients with histologically confirmed T1 CRC who participated in the Dutch Bowel Cancer Screening Programme and received endoscopic or surgical treatment between January 2014 and July 2017. Quality of life was measured using the European Organization for Research and Treatment 30-item Core Quality of Life Questionnaire and the 5-level EuroQoL 5-dimension questionnaire. We used the Cancer Worry Scale (CWS) to evaluate patients' fear of cancer recurrence. A question on perceived time to recovery after treatment was also included in the set of questionnaires sent to patients. RESULTS: Of all 119 eligible patients, 92.4% responded to the questionnaire (endoscopy group, 55/62; surgery group, 55/57). Compared with the surgery group, perceived time to recovery was on average 3 months shorter in endoscopically treated patients after adjustment for confounders (19.9 days vs 111.3 days; P = .001). The 2 treatment groups were comparable with regard to global quality of life, functioning domains, and symptom severity scores. Moreover, patients in the endoscopy group did not report more fear of cancer recurrence than those in the surgery group (CWS score, 0-40; endoscopy 7.6 vs surgery 9.7; P = .140). CONCLUSIONS: From the patient's perspective, endoscopic treatment provides a quicker recovery than surgery, without provoking more fear of cancer recurrence or any deterioration in quality of life. These results contribute to the shared therapeutic decision-making process of clinicians and T1 CRC patients.
show less
Download/Full Text
The full text of this publication is not available.
Keywords: Aged, Carcinoma/pathology, Clinical Decision-Making, Colonoscopy/methods, Colorectal Neoplasms/pathology, Convalescence/psychology, Cross-Sectional Studies, Digestive System Surgical Procedures/methods, Fear/psychology, Female, Humans, Linear Models, Male, Middle Aged, Multivariate Analysis, Neoplasm Recurrence, Local/psychology, Neoplasm Staging, Quality of Life/psychology, Time Factors, Transanal Endoscopic Microsurgery/methods, Gastroenterology, Radiology Nuclear Medicine and imaging, Journal Article
ISSN: 0016-5107
Publisher: Mosby Inc.
Note: Funding Information: We thank N. A. Osborne, J. M. Muller-van der Kolk (both from the department of Gastroenterology and Hepatology, Leiden University Medical Centre), A. H. Hekman, and H. J. Bertholee-Bosch (both from the department of Gastroenterology and Hepatology, Isala Hospital) for the logistical support and A. Farina Sarisqueta (Department of Pathology, Leiden University Medical Centre) for pathologic examination of the resected specimens. DISCLOSURE: The following author disclosed financial relationships relevant to this publication: J. J. Boonstra: Consultant for Boston Scientific. All other authors disclosed no financial relationships relevant to this publication. Publisher Copyright: © 2019 American Society for Gastrointestinal Endoscopy
(Peer reviewed)