Brown, SR, Mathew, R, Keding, A et al. (3 more authors) (2014) The impact of postoperative complications on long-term quality of life after curative colorectal cancer surgery. Annals of Surgery, 259 (5). 916 - 923. ISSN 0003-4932
Abstract
OBJECTIVE: To investigate the effect that complications have on patients' long-term quality of life (QoL) after curative colorectal cancer surgery. BACKGROUND: Colorectal cancer surgery is a high risk, with approximately 1 in 3 patients suffering a complication. The long-term consequences of postoperative complications are important but have poorly been documented. METHODS: The MRC-CLASICC trial (laparoscopic-assisted vs open surgery for colorectal cancer) included prospective evaluation of QoL using validated scoring questionnaires: EORTC QLQ-C30/CR38 and EQ5D. These were used to compare QoL at 3, 6, 18, and 36 months to baseline values for patients categorized into 2 groups: (i) those suffering any complication and (ii) those suffering any of 5 common complications (wound, chest, anastomotic leak, hemorrhage, and cardiac event). RESULTS: A total of 614 of 794 CLASICC patients were suitable for inclusion. Complications occurred in 215 (35.0%) patients, including: wound complications (61, 9.9%), chest infection (50, 8.1%), anastomotic leak (27, 4.4%), hemorrhage (14, 2.3%), and cardiac event (26, 4.2%). Significant long-term differences in QoL between patients with and without complications were found for Physical and Social Function, Role Functioning, and Body Image on EORTC QLQ-C30/QLQ-CR38 analysis and Mobility, Self-care, and Pain/Discomfort on EQ5D analysis. No significant differences were seen for emotional/cognitive functioning, global QoL, financial difficulties, or future perspectives. Risk factors of age, gender, ASA (American Society of Anesthesiologists) grade, and stoma moderated the impact of complications in the short- to medium-term QoL, but had less influence on long-term QoL. CONCLUSIONS: Postoperative complications have adverse effects on long-term QoL, particularly for Physical, Role and Social Functioning, and Body Image, as well as for Mobility, Self-care, and Pain/Discomfort. These findings should inform future preoperative counseling and health care planning.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Keywords: | Adult; aged; aged, 80 and over; colectomy; colorectal neoplasms; female; follow-up studies; Great Britain; humans; incidence; male; middle aged; postoperative complications; prospective studies; quality of life; questionnaires; risk factors; time factors |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 01 Apr 2015 10:33 |
Last Modified: | 24 Apr 2015 09:31 |
Published Version: | http://dx.doi.org/10.1097/SLA.0000000000000407 |
Status: | Published |
Publisher: | Lippincott, Williams & Wilkins |
Identification Number: | 10.1097/SLA.0000000000000407 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:84218 |