TY - JOUR
T1 - Quality of life and fear of cancer recurrence in T1 colorectal cancer patients treated with endoscopic or surgical tumor resection
AU - Dang, Hao
AU - de Vos Tot Nederveen Cappel, Wouter H
AU - van der Zwaan, Sarita M S
AU - van den Akker-van Marle, M Elske
AU - van Westreenen, Henderik L
AU - Backes, Yara
AU - Moons, Leon M G
AU - Holman, Fabian A
AU - Peeters, Koen C M J
AU - van der Kraan, Jolein
AU - Langers, Alexandra M J
AU - Lijfering, Willem M
AU - Hardwick, James C H
AU - Boonstra, Jurjen J
N1 - Funding Information:
We thank N. A. Osborne, J. M. Muller-van der Kolk (both from the department of Gastroenterology and Hepatology, Leiden University Medical Centre), A. H. Hekman, and H. J. Bertholee-Bosch (both from the department of Gastroenterology and Hepatology, Isala Hospital) for the logistical support and A. Farina Sarisqueta (Department of Pathology, Leiden University Medical Centre) for pathologic examination of the resected specimens. DISCLOSURE: The following author disclosed financial relationships relevant to this publication: J. J. Boonstra: Consultant for Boston Scientific. All other authors disclosed no financial relationships relevant to this publication.
Publisher Copyright:
© 2019 American Society for Gastrointestinal Endoscopy
PY - 2019/3
Y1 - 2019/3
N2 - BACKGROUND AND AIMS: To optimize therapeutic decision-making in early invasive colorectal cancer (T1 CRC) patients, it is important to elicit the patient's perspective next to considering medical outcome. Because empirical data on patient-reported impact of different treatment options are lacking, we evaluated patients' quality of life, perceived time to recovery, and fear of cancer recurrence after endoscopic or surgical treatment for T1 CRC.METHODS: In this cross-sectional study, we selected patients with histologically confirmed T1 CRC who participated in the Dutch Bowel Cancer Screening Programme and received endoscopic or surgical treatment between January 2014 and July 2017. Quality of life was measured using the European Organization for Research and Treatment 30-item Core Quality of Life Questionnaire and the 5-level EuroQoL 5-dimension questionnaire. We used the Cancer Worry Scale (CWS) to evaluate patients' fear of cancer recurrence. A question on perceived time to recovery after treatment was also included in the set of questionnaires sent to patients.RESULTS: Of all 119 eligible patients, 92.4% responded to the questionnaire (endoscopy group, 55/62; surgery group, 55/57). Compared with the surgery group, perceived time to recovery was on average 3 months shorter in endoscopically treated patients after adjustment for confounders (19.9 days vs 111.3 days; P = .001). The 2 treatment groups were comparable with regard to global quality of life, functioning domains, and symptom severity scores. Moreover, patients in the endoscopy group did not report more fear of cancer recurrence than those in the surgery group (CWS score, 0-40; endoscopy 7.6 vs surgery 9.7; P = .140).CONCLUSIONS: From the patient's perspective, endoscopic treatment provides a quicker recovery than surgery, without provoking more fear of cancer recurrence or any deterioration in quality of life. These results contribute to the shared therapeutic decision-making process of clinicians and T1 CRC patients.
AB - BACKGROUND AND AIMS: To optimize therapeutic decision-making in early invasive colorectal cancer (T1 CRC) patients, it is important to elicit the patient's perspective next to considering medical outcome. Because empirical data on patient-reported impact of different treatment options are lacking, we evaluated patients' quality of life, perceived time to recovery, and fear of cancer recurrence after endoscopic or surgical treatment for T1 CRC.METHODS: In this cross-sectional study, we selected patients with histologically confirmed T1 CRC who participated in the Dutch Bowel Cancer Screening Programme and received endoscopic or surgical treatment between January 2014 and July 2017. Quality of life was measured using the European Organization for Research and Treatment 30-item Core Quality of Life Questionnaire and the 5-level EuroQoL 5-dimension questionnaire. We used the Cancer Worry Scale (CWS) to evaluate patients' fear of cancer recurrence. A question on perceived time to recovery after treatment was also included in the set of questionnaires sent to patients.RESULTS: Of all 119 eligible patients, 92.4% responded to the questionnaire (endoscopy group, 55/62; surgery group, 55/57). Compared with the surgery group, perceived time to recovery was on average 3 months shorter in endoscopically treated patients after adjustment for confounders (19.9 days vs 111.3 days; P = .001). The 2 treatment groups were comparable with regard to global quality of life, functioning domains, and symptom severity scores. Moreover, patients in the endoscopy group did not report more fear of cancer recurrence than those in the surgery group (CWS score, 0-40; endoscopy 7.6 vs surgery 9.7; P = .140).CONCLUSIONS: From the patient's perspective, endoscopic treatment provides a quicker recovery than surgery, without provoking more fear of cancer recurrence or any deterioration in quality of life. These results contribute to the shared therapeutic decision-making process of clinicians and T1 CRC patients.
KW - Aged
KW - Carcinoma/pathology
KW - Clinical Decision-Making
KW - Colonoscopy/methods
KW - Colorectal Neoplasms/pathology
KW - Convalescence/psychology
KW - Cross-Sectional Studies
KW - Digestive System Surgical Procedures/methods
KW - Fear/psychology
KW - Female
KW - Humans
KW - Linear Models
KW - Male
KW - Middle Aged
KW - Multivariate Analysis
KW - Neoplasm Recurrence, Local/psychology
KW - Neoplasm Staging
KW - Quality of Life/psychology
KW - Time Factors
KW - Transanal Endoscopic Microsurgery/methods
UR - http://www.scopus.com/inward/record.url?scp=85057862498&partnerID=8YFLogxK
U2 - 10.1016/j.gie.2018.09.026
DO - 10.1016/j.gie.2018.09.026
M3 - Article
C2 - 30273589
SN - 0016-5107
VL - 89
SP - 533
EP - 544
JO - Gastrointestinal Endoscopy
JF - Gastrointestinal Endoscopy
IS - 3
ER -