Cancer Stage and Quality of Life in Colorectal Cancer

Cancer stage is an important indicator to predict patients’ survival and therefore assumed to influence their quality of life (QoL). The aim of this study was to analysis the relationship between cancer stage and QoL in a longitudinal investigation of ambulatory patients with colorectal cancer.

This was a prospective longitudinal research design. The Chinese version EORTC Quality of Life Core Questionnaire (QLQ-C30) was administered to patients at 4 time points: the first month after operation (baseline), 3^rd, 6^th, and 12^th month after initial operation. Cancer stage at diagnosis and treatment data was obtained from patients’ medical records. Patients was categorized into early stage (T0, T1-T2, n= 31) and advance stage (T4-T5, n= 16). Mann-Whitney U Test, Chi-squared test and Fisher exact test were used to compare the demographic and treatment date between stage groups. Generalized Estimating Equations (GEE) was used to compare the mean QoL for stage group across time.

From October, 2006 to July, 200, we enrolled 73 eligible cases, and 47 patients agreed to participate in this study. Respondents and non-respondents did not differ in all demographic and treatment data. The mean age of early and advance stage patients was 63.8 and 60.6 years. The percentage of stoma was 9.7% for early patients and 12.5% for advance patients. Advance patients had higher percentage underwent adjuvant therapy (p= .003) than early ones. Cancer stage of colorectal cancer was significantly associated with partial EORTC scales (fatigue, pain, role function, social function, global QoL and finical difficult). Fatigue in early stage patients presented decrease pattern, on the contrary, advanced patients got worse status from 3 to 12 months(p= .02). Early stage patients had better role and social function during 3 to 12 months, however, advanced patients got worse functioning in the follow up period(p= .01, .03).

Advanced cancer stage patients appear to be associated with severe symptom and psychosocial distress. These results have suggested that understand the impacts of progression of colorectal cancer on patients’ quality of life.