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Quality of Life Among Disease-Free Survivors of Rectal Cancer

From the Surgical Department and Medical Oncology Department, Centre Alexis Vautrin; the School of Public Health and Medicine University, Vandoeuvre lès Nancy; and the Radiotherapy Department, University Hospital, Besançon, France

Address reprint requests to Philippe Rauch, MD, Centre Alexis Vautrin, 54511 Vandoeuvre lès Nancy, France; e-mail: p.rauch{at}nancy.fnclcc.fr

PURPOSE: To identify factors affecting the quality of life (QoL) of disease-free survivors of rectal cancer.

PATIENTS AND METHODS: One hundred twenty-one patients in complete remission more than 2 years after diagnosis were asked to complete three QoL questionnaires: the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30; its colorectal module, QLQ-CR38; and the Duke generic instrument.

RESULTS: Patients reported less pain (P = .002) than did controls drawn from the general population. EORTC QLQ-C30 physical scores were also higher among rectal cancer survivors than in the general Norwegian or German population (P = .0005 and P = .002, respectively). Unexpectedly, stoma patients reported better social functioning than did nonstoma patients (P = .005), with less anxiety (P = .008) and higher self-esteem (P = .0002). In the present authors' experience, the QLQ-CR38 does not discriminate between these groups. Residual abdominal or pelvic pain and constipation had the most negative influence on QoL.

CONCLUSION: QoL is high among rectal cancer survivors, including stoma patients. Simultaneous use of several QoL questionnaires appears to have value in follow-up and in monitoring the effects of therapy. The impact of residual pain and constipation on long-term QoL should be considered when establishing a treatment regimen.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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