Association of laparoscopic colectomy versus open colectomy on the long-term health-related quality of life of colon can
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and Other Interventional Techniques
Association of laparoscopic colectomy versus open colectomy on the long‑term health‑related quality of life of colon cancer survivors Melissa S. Y. Thong1 · Lina Jansen2 · Jenny Chang‑Claude3,4 · Michael Hoffmeister2 · Hermann Brenner2,5,6 · Volker Arndt1 Received: 4 September 2019 / Accepted: 24 December 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Laparoscopic colectomy (LC) is a less invasive alternative to open colectomy (OC) in the treatment of stage I–III colon cancer. Research on the long-term (5-year post-diagnosis) health-related quality of life (HRQOL) of LC patients is scarce. Our study aimed to compare the long-term HRQOL and psychological well-being of stage I–III colon cancer survivors treated either with LC or OC. Methods This study used a German population-based cohort of patients treated with either LC (n = 86) or OC (n = 980). LC patients were matched to OC patients using a propensity score. At 5-year follow-up, patients completed assessments on HRQOL (EORTC QLQ-C30 and EORTC QLQ-CR29) and psychological well-being (distress and disease/treatment burden). Least square mean scores of HRQOL were derived using linear regression. Proportions of patients with moderate/ high distress and disease/treatment burden were compared with Chi-square tests. Results In total, 81 LC patients were matched to 156 OC patients. Generally, LC patients had HRQOL comparable to OC patients, albeit LC patients reported significantly better body image (87.1 versus 81.0, p = 0.03). Distress levels were generally low and comparable between the two groups, even though LC patients were more likely to experience disease recurrence (16% versus 7%, p = 0.02) than OC patients. OC patients were more likely to feel moderate/high levels of burden associated with the treatment (72% versus 56%, p = 0.01) and the time after treatment completion (43% versus 28%, p = 0.02). Conclusion LC patients reported comparable long-term HRQOL outcomes but higher levels of psychological well-being than OC patients 5 years after diagnosis, even though LC was associated with higher risk of disease recurrence. Keywords Colon cancer · Health-related quality of life · Laparoscopy · Long-term survivor · Population based · Propensity score Laparoscopic colectomy (LC) is increasingly adopted as a less invasive alternative to traditional open colectomy (OC) for the curative treatment of stage I–III colon cancer.
Results from randomized clinical trials show that LC had more favorable short-term clinical outcomes such as less peri-/post-operative complications and shorter hospital stay,
* Melissa S. Y. Thong [email protected]
4
Genetic Tumour Epidemiology Group, University Medical Center Hamburg-Eppendorf, University Cancer Center Hamburg, Hamburg, Germany
5
Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
6
German Cancer Consortium (DKTK), German Cancer Research
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