Predictors of Long-Term Quality of Life for Survivors of Stage II/III Rectal Cancer in the Cancer Care Outcomes Research and Surveillance Consortium

Mary E Charlton; Karyn B Stitzenberg; Chi Lin; Jennifer A Schlichting; Thorvardur R Halfdanarson; Grelda Yazmin Juarez; Jane F Pendergast; Elizabeth A Chrischilles; Robert B Wallace

doi:10.1200/JOP.2015.004564

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Predictors of Long-Term Quality of Life for Survivors of Stage II/III Rectal Cancer in the Cancer Care Outcomes Research and Surveillance Consortium

Journal article

Open access

Peer reviewed

Predictors of Long-Term Quality of Life for Survivors of Stage II/III Rectal Cancer in the Cancer Care Outcomes Research and Surveillance Consortium

Mary E Charlton, Karyn B Stitzenberg, Chi Lin, Jennifer A Schlichting, Thorvardur R Halfdanarson, Grelda Yazmin Juarez, Jane F Pendergast, Elizabeth A Chrischilles and Robert B Wallace

Journal of oncology practice, Vol.11(4), pp.e476-e486

07/2015

DOI: 10.1200/JOP.2015.004564

PMCID: PMC4507395

PMID: 26080831

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Abstract

Many patients do not receive guideline-recommended neoadjuvant chemoradiotherapy for resectable rectal cancer. Little is known regarding long-term quality of life (QOL) associated with various treatment approaches. Our objective was to determine patient characteristics and subsequent QOL associated with treatment approach. Our study was a geographically diverse population- and health system-based cohort study that included adults age 21 years or older with newly diagnosed stage II/III rectal cancer who were recruited from 2003 to 2005. Eligible patients were contacted 1 to 4 months after diagnosis and asked to participate in a telephone survey and to consent to medical record review, with separate follow-up QOL surveys conducted 1 and 7 years after diagnosis. Two hundred thirty-nine patients with stage II/III rectal cancer were included in this analysis. Younger age (< 65 v ≥ 65 years: odds ratio, 2.49; 95% CI, 1.33 to 4.65) was significantly associated with increased odds of receiving neoadjuvant or adjuvant chemoradiotherapy. The adjuvant chemoradiotherapy group had significantly worse mean EuroQol-5D (range, 0 to 1) and Short Form-12 physical health component scores (standardized mean, 50) at 1-year follow-up than the neoadjuvant chemoradiotherapy group (0.75 v 0.85; P = .002; 37.2 v 43.3; P = .01, respectively) and the group that received only one or neither form of treatment (0.75 v 0.85; P = .02; 37.2 v 45.1; P = .008, respectively). Neoadjuvant treatment may result in better QOL and functional status 1 year after diagnosis. Further evaluation of patient and provider reasons for not pursuing neoadjuvant therapy is necessary to determine how and where to target process improvement and/or education efforts to ensure that patients have access to recommended treatment options.

Age Factors

Humans

Middle Aged

Survivors - statistics & numerical data

Male

Mental Health

Chemotherapy, Adjuvant - statistics & numerical data

Neoadjuvant Therapy - statistics & numerical data

Rectal Neoplasms - therapy

Disease-Free Survival

Time Factors

Quality of Life

Radiotherapy, Adjuvant - statistics & numerical data

Chemoradiotherapy, Adjuvant - statistics & numerical data

Female

Surveys and Questionnaires

Aged

Rectal Neoplasms - pathology

Survivors - psychology

Health Status

Neoplasm Staging

Patient Education as Topic

Details

Title: Subtitle: Predictors of Long-Term Quality of Life for Survivors of Stage II/III Rectal Cancer in the Cancer Care Outcomes Research and Surveillance Consortium
Creators: Mary E Charlton - University of Iowa College of Public Health, Iowa City, IA; UNC Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; University of Nebraska Medical Center, Omaha, NE; and Mayo Clinic Cancer Center, Scottsdale, AZ mary-charlton@uiowa.edu
Karyn B Stitzenberg - University of Iowa College of Public Health, Iowa City, IA; UNC Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; University of Nebraska Medical Center, Omaha, NE; and Mayo Clinic Cancer Center, Scottsdale, AZ
Chi Lin - University of Iowa College of Public Health, Iowa City, IA; UNC Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; University of Nebraska Medical Center, Omaha, NE; and Mayo Clinic Cancer Center, Scottsdale, AZ
Jennifer A Schlichting - University of Iowa College of Public Health, Iowa City, IA; UNC Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; University of Nebraska Medical Center, Omaha, NE; and Mayo Clinic Cancer Center, Scottsdale, AZ
Thorvardur R Halfdanarson - University of Iowa College of Public Health, Iowa City, IA; UNC Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; University of Nebraska Medical Center, Omaha, NE; and Mayo Clinic Cancer Center, Scottsdale, AZ
Grelda Yazmin Juarez - University of Iowa College of Public Health, Iowa City, IA; UNC Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; University of Nebraska Medical Center, Omaha, NE; and Mayo Clinic Cancer Center, Scottsdale, AZ
Jane F Pendergast - University of Iowa College of Public Health, Iowa City, IA; UNC Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; University of Nebraska Medical Center, Omaha, NE; and Mayo Clinic Cancer Center, Scottsdale, AZ
Elizabeth A Chrischilles - University of Iowa College of Public Health, Iowa City, IA; UNC Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; University of Nebraska Medical Center, Omaha, NE; and Mayo Clinic Cancer Center, Scottsdale, AZ
Robert B Wallace - University of Iowa College of Public Health, Iowa City, IA; UNC Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; University of Nebraska Medical Center, Omaha, NE; and Mayo Clinic Cancer Center, Scottsdale, AZ
Resource Type: Journal article
Publication Details: Journal of oncology practice, Vol.11(4), pp.e476-e486
DOI: 10.1200/JOP.2015.004564
PMID: 26080831
PMCID: PMC4507395
NLM abbreviation: J Oncol Pract
ISSN: 1935-469X
eISSN: 1935-469X
Publisher: United States
Grant note: P30 ES005605 / NIEHS NIH HHS U01 CA093344 / NCI NIH HHS U01 CA093326 / NCI NIH HHS U01 CA093324 / NCI NIH HHS U01 CA093339 / NCI NIH HHS U01 CA093332 / NCI NIH HHS U01 CA093348 / NCI NIH HHS U01 CA093329 / NCI NIH HHS P30 CA086862 / NCI NIH HHS
Language: English
Date published: 07/2015
Academic Unit: Pharmacy; Health Management and Policy; Epidemiology; Biostatistics; Injury Prevention Research Center; Internal Medicine
Record Identifier: 9983995044002771

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