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Patient‐reported outcomes in long‐term survivors of metastatic colorectal cancer needing liver resection.

Published: 19th August 2014

Authors: J. R. Rees, J. M. Blazeby, S. T. Brookes, T. John, F. K. Welsh, M. Rees et al.

Background

Five‐year survival after hepatic resection for colorectal cancer (CRC) liver metastases is good, but data on patient‐reported outcomes are lacking. This study describes the long‐term impact of liver surgery for CRC metastases on patient‐reported outcomes.

Method

The study used the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) C30 and the disease‐specific module, EORTC QLQ‐LMC21. For functional scales, mean scores out of 100 with 95 per cent c.i. were calculated; differences of 10 points or more were considered clinically significant. Responses to symptom scales and items were categorized as ‘minimal’ or ‘severe’. Proportions and 95 per cent c.i. for symptoms were calculated.

Results

A total of 241 patients were recruited; nine (3·7 per cent) had unresectable disease and were excluded. Some 68 (42 men) of 80 long‐term survivors participated; their mean age was 69·5 years and median follow‐up was 8·0 (range 6·9–9·2) years. Values for baseline and 1‐year patient‐reported outcome data were similar. Scores for functional scales were excellent (emotional function: 92, 95 per cent c.i. 87 to 96; social function: 94, 89 to 99; role function: 94, 90 to 98), reflecting clinically significant improvements from baseline values of 17 (10 to 24), 12 (3 to 21) and 12 (3 to 20) respectively. Severe symptoms were uncommon (affected less than 5 per cent of patients) for most patient‐reported outcome scales or items, but persistent severe symptoms were noted for sexual function (2 per cent increase from baseline), peripheral neuropathy (2 per cent increase), constipation (10 per cent increase) and diarrhoea (5 per cent increase).

Conclusion

Long‐term survivors of metastatic colorectal cancer who have undergone liver surgery have excellent global quality of life, high levels of function and few symptoms.

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