Chemotherapy reduces long‐term quality of life in recurrence‐free colon cancer survivors (LaTE study)—a nationwide inverse probability of treatment‐weighted registry‐based cohort study and survey
Aim Stage III colon cancer is routinely treated with adjuvant chemotherapy, which causes significant short‐term morbidity. Its effect on long‐term quality of life (QoL) is poorly investigated. The aim of this study was to investigate long‐term QoL after curative treatment for colon cancer and explor...
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| Veröffentlicht in: | Colorectal disease 2024-01, Vol.26 (1), p.22-33 |
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| creator | Malik, Yasir G. Benth, Jūratė Šaltytė Hamre, Hanne M. Færden, Arne E. Ignjatovic, Dejan Schultz, Johannes K. |
| description | Aim
Stage III colon cancer is routinely treated with adjuvant chemotherapy, which causes significant short‐term morbidity. Its effect on long‐term quality of life (QoL) is poorly investigated. The aim of this study was to investigate long‐term QoL after curative treatment for colon cancer and explore the impact of chemotherapy on general and disease‐specific QoL.
Method
All patients aged under 75 years operated on for colon cancer between 30 September 2007 and 1 October 2019 were identified by the Cancer Registry of Norway. Exclusion criteria were distant metastasis, recurrence, dementia and rectal/rectosigmoid cancer operation. The primary outcome measure was Gastrointestinal Quality of Life Index (GIQLI). Secondary outcome measures included the Short Form Health Survey (SF‐36). To achieve balanced groups when assessing differences in outcome measures the analyses were weighted by inverse probability weights based on a multiple logistic regression model with prechosen confounders.
Results
A total of 8627 patients were invited and 3109 responded (36% response rate). After exclusions 3025 patients were included, of whom 1148 (38%) had received adjuvant chemotherapy and 1877 (62%) had surgery alone, with mean follow‐up of 75.5 versus 74.5 months, respectively. The GIQLI differed significantly between the groups [mean 111.0 (SD 18.4) vs. 115.6 (SD 17.8), respectively; mean difference: −4.6 (95% CI −5.9; −3.2); p |
| doi_str_mv | 10.1111/codi.16807 |
| format | Article |
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Stage III colon cancer is routinely treated with adjuvant chemotherapy, which causes significant short‐term morbidity. Its effect on long‐term quality of life (QoL) is poorly investigated. The aim of this study was to investigate long‐term QoL after curative treatment for colon cancer and explore the impact of chemotherapy on general and disease‐specific QoL.
Method
All patients aged under 75 years operated on for colon cancer between 30 September 2007 and 1 October 2019 were identified by the Cancer Registry of Norway. Exclusion criteria were distant metastasis, recurrence, dementia and rectal/rectosigmoid cancer operation. The primary outcome measure was Gastrointestinal Quality of Life Index (GIQLI). Secondary outcome measures included the Short Form Health Survey (SF‐36). To achieve balanced groups when assessing differences in outcome measures the analyses were weighted by inverse probability weights based on a multiple logistic regression model with prechosen confounders.
Results
A total of 8627 patients were invited and 3109 responded (36% response rate). After exclusions 3025 patients were included, of whom 1148 (38%) had received adjuvant chemotherapy and 1877 (62%) had surgery alone, with mean follow‐up of 75.5 versus 74.5 months, respectively. The GIQLI differed significantly between the groups [mean 111.0 (SD 18.4) vs. 115.6 (SD 17.8), respectively; mean difference: −4.6 (95% CI −5.9; −3.2); p < 0.001]. Those with the highest neurotoxicity exhibited the lowest GIQLI. The adjuvant chemotherapy group scored significantly lower in six of eight SF‐36 domains compared with the surgery alone group. The main differences were found in social, physical and emotional function.
Conclusion
Long‐term QoL was significantly lower in patients who received adjuvant chemotherapy than in patients who did not. Neurotoxicity was closely related to reduced QoL in these patients. The low response rate limits the generalizability of the results.</description><identifier>ISSN: 1462-8910</identifier><identifier>EISSN: 1463-1318</identifier><identifier>DOI: 10.1111/codi.16807</identifier><identifier>PMID: 38036898</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>adjuvant chemotherapy ; Aged ; Cancer Survivors ; Chemotherapy ; Chemotherapy, Adjuvant - methods ; Cohort Studies ; Colon cancer ; Colonic Neoplasms - drug therapy ; Colonic Neoplasms - surgery ; Colorectal cancer ; Dementia disorders ; Humans ; inverse probability of treatment weighting ; long‐term quality of life ; Metastases ; Morbidity ; nationwide ; Neoplasm Recurrence, Local ; Neurotoxicity ; Patients ; Quality of Life ; Registries ; Response rates ; Surgery ; Surveys</subject><ispartof>Colorectal disease, 2024-01, Vol.26 (1), p.22-33</ispartof><rights>2023 The Authors. published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.</rights><rights>2023 The Authors. Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.</rights><rights>2023. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3937-87d640bbb1783734083c92b25a6049b4c094e9d58f15725c26562c3b15e384423</citedby><cites>FETCH-LOGICAL-c3937-87d640bbb1783734083c92b25a6049b4c094e9d58f15725c26562c3b15e384423</cites><orcidid>0000-0002-9427-2087 ; 0000-0002-8565-0568 ; 0000-0002-2389-1403</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fcodi.16807$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fcodi.16807$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38036898$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Malik, Yasir G.</creatorcontrib><creatorcontrib>Benth, Jūratė Šaltytė</creatorcontrib><creatorcontrib>Hamre, Hanne M.</creatorcontrib><creatorcontrib>Færden, Arne E.</creatorcontrib><creatorcontrib>Ignjatovic, Dejan</creatorcontrib><creatorcontrib>Schultz, Johannes K.</creatorcontrib><title>Chemotherapy reduces long‐term quality of life in recurrence‐free colon cancer survivors (LaTE study)—a nationwide inverse probability of treatment‐weighted registry‐based cohort study and survey</title><title>Colorectal disease</title><addtitle>Colorectal Dis</addtitle><description>Aim
Stage III colon cancer is routinely treated with adjuvant chemotherapy, which causes significant short‐term morbidity. Its effect on long‐term quality of life (QoL) is poorly investigated. The aim of this study was to investigate long‐term QoL after curative treatment for colon cancer and explore the impact of chemotherapy on general and disease‐specific QoL.
Method
All patients aged under 75 years operated on for colon cancer between 30 September 2007 and 1 October 2019 were identified by the Cancer Registry of Norway. Exclusion criteria were distant metastasis, recurrence, dementia and rectal/rectosigmoid cancer operation. The primary outcome measure was Gastrointestinal Quality of Life Index (GIQLI). Secondary outcome measures included the Short Form Health Survey (SF‐36). To achieve balanced groups when assessing differences in outcome measures the analyses were weighted by inverse probability weights based on a multiple logistic regression model with prechosen confounders.
Results
A total of 8627 patients were invited and 3109 responded (36% response rate). After exclusions 3025 patients were included, of whom 1148 (38%) had received adjuvant chemotherapy and 1877 (62%) had surgery alone, with mean follow‐up of 75.5 versus 74.5 months, respectively. The GIQLI differed significantly between the groups [mean 111.0 (SD 18.4) vs. 115.6 (SD 17.8), respectively; mean difference: −4.6 (95% CI −5.9; −3.2); p < 0.001]. Those with the highest neurotoxicity exhibited the lowest GIQLI. The adjuvant chemotherapy group scored significantly lower in six of eight SF‐36 domains compared with the surgery alone group. The main differences were found in social, physical and emotional function.
Conclusion
Long‐term QoL was significantly lower in patients who received adjuvant chemotherapy than in patients who did not. Neurotoxicity was closely related to reduced QoL in these patients. The low response rate limits the generalizability of the results.</description><subject>adjuvant chemotherapy</subject><subject>Aged</subject><subject>Cancer Survivors</subject><subject>Chemotherapy</subject><subject>Chemotherapy, Adjuvant - methods</subject><subject>Cohort Studies</subject><subject>Colon cancer</subject><subject>Colonic Neoplasms - drug therapy</subject><subject>Colonic Neoplasms - surgery</subject><subject>Colorectal cancer</subject><subject>Dementia disorders</subject><subject>Humans</subject><subject>inverse probability of treatment weighting</subject><subject>long‐term quality of life</subject><subject>Metastases</subject><subject>Morbidity</subject><subject>nationwide</subject><subject>Neoplasm Recurrence, Local</subject><subject>Neurotoxicity</subject><subject>Patients</subject><subject>Quality of Life</subject><subject>Registries</subject><subject>Response rates</subject><subject>Surgery</subject><subject>Surveys</subject><issn>1462-8910</issn><issn>1463-1318</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>EIF</sourceid><recordid>eNp9kctu1DAUhiMEoqWw4QGQJTYFKcWXxHGWaChQaaRuyjqynZMZV0k89WVG2fURWPBavESfBGfSsmCBN7Z-ff7Okf4se0vwBUnnk7atuSBc4OpZdkoKznLCiHh-fNNc1ASfZK-8v8WY8IqIl9kJE5hxUYvT7PdqC4MNW3ByNyEHbdTgUW_HzcP9zwBuQHdR9iZMyHaoNx0gMyZMR-dg1JCgzgEgbdMXpGWKHPLR7c3eOo_O1_LmEvkQ2-nDw_0viUYZjB0Ppp09e3Ae0M5ZJZV5mhEcyDDAGJL6AGazDdCmgRvjg5tSpqRPgbZb68JiRnJsjzNhep296GTv4c3jfZb9-Hp5s_qer6-_Xa0-r3PNalblomp5gZVSpBKsYgUWTNdU0VJyXNSq0LguoG5L0ZGyoqWmvORUM0VKYKIoKDvLzhdvWv4ugg_NYLyGvpcj2OgbKupUB8V4Rt__g97a6Ma0XUNrInhZUD5THxdKO-u9g67ZOTNINzUEN3PJzVxycyw5we8elVEN0P5Fn1pNAFmAg-lh-o-qWV1_uVqkfwC-Irqj</recordid><startdate>202401</startdate><enddate>202401</enddate><creator>Malik, Yasir G.</creator><creator>Benth, Jūratė Šaltytė</creator><creator>Hamre, Hanne M.</creator><creator>Færden, Arne E.</creator><creator>Ignjatovic, Dejan</creator><creator>Schultz, Johannes K.</creator><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TM</scope><scope>7TO</scope><scope>H94</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-9427-2087</orcidid><orcidid>https://orcid.org/0000-0002-8565-0568</orcidid><orcidid>https://orcid.org/0000-0002-2389-1403</orcidid></search><sort><creationdate>202401</creationdate><title>Chemotherapy reduces long‐term quality of life in recurrence‐free colon cancer survivors (LaTE study)—a nationwide inverse probability of treatment‐weighted registry‐based cohort study and survey</title><author>Malik, Yasir G. ; Benth, Jūratė Šaltytė ; Hamre, Hanne M. ; Færden, Arne E. ; Ignjatovic, Dejan ; Schultz, Johannes K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3937-87d640bbb1783734083c92b25a6049b4c094e9d58f15725c26562c3b15e384423</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>adjuvant chemotherapy</topic><topic>Aged</topic><topic>Cancer Survivors</topic><topic>Chemotherapy</topic><topic>Chemotherapy, Adjuvant - methods</topic><topic>Cohort Studies</topic><topic>Colon cancer</topic><topic>Colonic Neoplasms - drug therapy</topic><topic>Colonic Neoplasms - surgery</topic><topic>Colorectal cancer</topic><topic>Dementia disorders</topic><topic>Humans</topic><topic>inverse probability of treatment weighting</topic><topic>long‐term quality of life</topic><topic>Metastases</topic><topic>Morbidity</topic><topic>nationwide</topic><topic>Neoplasm Recurrence, Local</topic><topic>Neurotoxicity</topic><topic>Patients</topic><topic>Quality of Life</topic><topic>Registries</topic><topic>Response rates</topic><topic>Surgery</topic><topic>Surveys</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Malik, Yasir G.</creatorcontrib><creatorcontrib>Benth, Jūratė Šaltytė</creatorcontrib><creatorcontrib>Hamre, Hanne M.</creatorcontrib><creatorcontrib>Færden, Arne E.</creatorcontrib><creatorcontrib>Ignjatovic, Dejan</creatorcontrib><creatorcontrib>Schultz, Johannes K.</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Colorectal disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Malik, Yasir G.</au><au>Benth, Jūratė Šaltytė</au><au>Hamre, Hanne M.</au><au>Færden, Arne E.</au><au>Ignjatovic, Dejan</au><au>Schultz, Johannes K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Chemotherapy reduces long‐term quality of life in recurrence‐free colon cancer survivors (LaTE study)—a nationwide inverse probability of treatment‐weighted registry‐based cohort study and survey</atitle><jtitle>Colorectal disease</jtitle><addtitle>Colorectal Dis</addtitle><date>2024-01</date><risdate>2024</risdate><volume>26</volume><issue>1</issue><spage>22</spage><epage>33</epage><pages>22-33</pages><issn>1462-8910</issn><eissn>1463-1318</eissn><abstract>Aim
Stage III colon cancer is routinely treated with adjuvant chemotherapy, which causes significant short‐term morbidity. Its effect on long‐term quality of life (QoL) is poorly investigated. The aim of this study was to investigate long‐term QoL after curative treatment for colon cancer and explore the impact of chemotherapy on general and disease‐specific QoL.
Method
All patients aged under 75 years operated on for colon cancer between 30 September 2007 and 1 October 2019 were identified by the Cancer Registry of Norway. Exclusion criteria were distant metastasis, recurrence, dementia and rectal/rectosigmoid cancer operation. The primary outcome measure was Gastrointestinal Quality of Life Index (GIQLI). Secondary outcome measures included the Short Form Health Survey (SF‐36). To achieve balanced groups when assessing differences in outcome measures the analyses were weighted by inverse probability weights based on a multiple logistic regression model with prechosen confounders.
Results
A total of 8627 patients were invited and 3109 responded (36% response rate). After exclusions 3025 patients were included, of whom 1148 (38%) had received adjuvant chemotherapy and 1877 (62%) had surgery alone, with mean follow‐up of 75.5 versus 74.5 months, respectively. The GIQLI differed significantly between the groups [mean 111.0 (SD 18.4) vs. 115.6 (SD 17.8), respectively; mean difference: −4.6 (95% CI −5.9; −3.2); p < 0.001]. Those with the highest neurotoxicity exhibited the lowest GIQLI. The adjuvant chemotherapy group scored significantly lower in six of eight SF‐36 domains compared with the surgery alone group. The main differences were found in social, physical and emotional function.
Conclusion
Long‐term QoL was significantly lower in patients who received adjuvant chemotherapy than in patients who did not. Neurotoxicity was closely related to reduced QoL in these patients. The low response rate limits the generalizability of the results.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>38036898</pmid><doi>10.1111/codi.16807</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-9427-2087</orcidid><orcidid>https://orcid.org/0000-0002-8565-0568</orcidid><orcidid>https://orcid.org/0000-0002-2389-1403</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | adjuvant chemotherapy Aged Cancer Survivors Chemotherapy Chemotherapy, Adjuvant - methods Cohort Studies Colon cancer Colonic Neoplasms - drug therapy Colonic Neoplasms - surgery Colorectal cancer Dementia disorders Humans inverse probability of treatment weighting long‐term quality of life Metastases Morbidity nationwide Neoplasm Recurrence, Local Neurotoxicity Patients Quality of Life Registries Response rates Surgery Surveys |
| title | Chemotherapy reduces long‐term quality of life in recurrence‐free colon cancer survivors (LaTE study)—a nationwide inverse probability of treatment‐weighted registry‐based cohort study and survey |
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