Health-Related Quality of Life in Metastatic Colorectal Cancer Patients Treated with Curative Resection and/or Local Ablative Therapy or Systemic Therapy in the Finnish RAXO-Study

Kaisa Lehtomäki, Hanna P. Stedt, Emerik Osterlund, Timo Muhonen, Leena Maija Soveri, Päivi Halonen, Tapio K. Salminen, Juha Kononen, Raija Kallio, Annika Ålgars, Eetu Heervä, Annamarja Lamminmäki, Aki Uutela, Arno Nordin, Juho Lehto, Tiina Saarto, Harri Sintonen, Pirkko Liisa Kellokumpu-Lehtinen, Raija Ristamäki, Bengt GlimeliusHelena Isoniemi, Pia Osterlund

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    11 Citations (Scopus)
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    Abstract

    Metastasectomy and/or local ablative therapy in metastatic colorectal cancer (mCRC) patients often provide long-term survival. Health-related quality of life (HRQoL) data in curatively treated mCRC are limited. In the RAXO-study that evaluated repeated resectability, a multi-crosssectional HRQoL substudy with 15D, EQ-5D-3L, QLQ-C30, and QLQ-CR29 questionnaires was conducted. Mean values of patients in different treatment groups were compared with age-and gender-standardized general Finnish populations. The questionnaire completion rate was 444/477 patients (93%, 1751 questionnaires). Mean HRQoL was 0.89–0.91 with the 15D, 0.85–0.87 with the EQ-5D, 68–80 with the EQ-5D-VAS, and 68–79 for global health status during curative treatment phases, with improvements in the remission phase (disease-free >18 months). In the remission phase, mean EQ-5D and 15D scores were similar to the general population. HRQoL remained stable during first-to later-line treatments, when the aim was no longer cure, and declined notably when tumourcontrolling therapy was no longer meaningful. The symptom burden affecting mCRC survivors’ well-being included insomnia, impotence, urinary frequency, and fatigue. Symptom burden was lower after treatment and slightly higher, though stable, through all phases of systemic therapy. HRQoL was high in curative treatment phases, further emphasizing the strategy of metastasectomy in mCRC when clinically meaningful.

    Original languageEnglish
    Article number1713
    Number of pages21
    JournalCancers
    Volume14
    Issue number7
    DOIs
    Publication statusPublished - Mar 2022
    Publication typeA1 Journal article-refereed

    Funding

    Funding: This investigator-initiated study was supported by Finska Läkaresällskapet (2016, 2018, 2019, 2020, 2021, 2022), The Finnish Cancer Foundation (2019-2020, 2021, 2022-2023), the Competitive State Research Financing of the Expert Responsibility Area of Tampere, Helsinki, Turku, Kuopio, Oulu, and Satakunta Hospitals (2012, 2016, 2017, 2018, 2019, 2020, 2021, 2022), Tampere University Hospital Fund (Tukisäätiö 2019, 2020 and OOO-project 2020), Helsinki University Hospital research fund (2019, 2020, 2021, 2022), and the infrastructure with the database and study nurses partly supported by pharmaceutical companies (Amgen—unrestricted grant, Lilly, Merck KGaA, Roche Oy, Sanofi and Servier—unrestricted grant). The funders had no role in the study design, analysis, interpretation of the data or decision to publish. Conflicts of Interest: All authors report institutional research funding from Eli Lilly, Merck KGaA, Roche Finland, Sanofi and unrestricted grants from Amgen and Servier, during the conduct of the study. K.L., H.P.S., E.O., T.M., L.M.S.; P.H., T.K.S., J.K., R.K., A.Å., E.H., A.L.; A.U., A.N., R.R, B.G., H.I. and P.O. report grants, personal fees or non-financial support from Abbvie, Amgen, Astra-Zeneca, Baxalta/Shire, Bayer, BMS, Celgene, Eisai/Ewopharma, Eli Lilly, Erythech Pharma, Fresenius, Incyte, Jansen-Cilag, Medicom, Merck, MSD, Nordic Drugs/Pharma, Novartis, Nutricia/Danone, Pierre-Fabre, Roche, Sanofi, Servier, Sobi and/or Varian. This investigator-initiated study was supported by Finska L?kares?llskapet (2016, 2018, 2019, 2020, 2021, 2022), The Finnish Cancer Foundation (2019-2020, 2021, 2022-2023), the Competitive State Research Financing of the Expert Responsibility Area of Tampere, Helsinki, Turku, Kuopio, Oulu, and Satakunta Hospitals (2012, 2016, 2017, 2018, 2019, 2020, 2021, 2022), Tampere University Hospital Fund (Tukis??ti? 2019, 2020 and OOO-project 2020), Helsinki University Hospital research fund (2019, 2020, 2021, 2022), and the infrastructure with the database and study nurses partly supported by pharmaceutical companies (Amgen?unrestricted grant, Lilly, Merck KGaA, Roche Oy, Sanofi and Servier?unrestricted grant). The funders had no role in the study design, analysis, interpretation of the data or decision to publish.

    Keywords

    • 15D
    • chemotherapy
    • EQ-5D
    • health-related quality of life
    • local ablative therapy
    • metastasectomy
    • metastatic colorectal cancer
    • QLQ-C30
    • QLQ-CR29
    • systemic therapy

    Publication forum classification

    • Publication forum level 1

    ASJC Scopus subject areas

    • Oncology
    • Cancer Research

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