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Comparison of changes in health-related quality of life between elderly and non-elderly patients undergoing elective surgery for colorectal cancer

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Abstract

Purpose

Elderly people are thought to be more likely than their non-elderly counterparts to experience a decline in activities of daily living (ADL) and quality of life (QOL) due to the onset and treatment of disease. In this study, we investigated whether there was an age-related difference in changes in health-related QOL indices after surgical resection of colorectal cancer (CRC).

Methods

Patients who underwent elective surgery for primary CRC at our hospital between September 2017 and November 2021 were enrolled. Changes in QOL after surgery were evaluated after dividing the study population into a non-elderly (NE) group (younger than 75 years) and an elderly (E) group. A Short-Form 36-Item Health Survey was used as an index of QOL. The subscale and component summary scores before and 6 months after surgery were compared.

Results

Forty-seven patients were included in the E group and 166 patients were the NE group. The E group had significantly worse preoperative performance and physical status than the NE group. However, indices of physical function were not worsened after surgery in either group. In the NE group, there were significant decreases in role physical and role component summary scores and significant increases in general health, mental health, and mental component summary scores. In the E group, there were no significant changes in the subscale or component summary scores after surgery.

Conclusion

Our study demonstrated elderly patient did not necessarily show a decline in QOL more than non-elderly patients after CRC surgery. Surgical resection for CRC should be considered even for elderly patients, while considering possible risk factors for worsening ADL and QOL.

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Data availability

The data and materials are available on reasonable request from the corresponding author.

References

  1. Gill TM, Allore HG, Holford TR, Guo ZH (2004) Hospitalization, restricted activity, and the development of disability among older persons. JAMA 292:2115–2124. https://doi.org/10.1001/jama.292.17.2115

    Article  CAS  PubMed  Google Scholar 

  2. Covinsky KE, Palmer RM, Fortinsky RH, Counsell SR, Stewart AL, Kresevic D, Burant CJ, Landefeld CS (2003) Loss of independence in activities of daily living in older adults hospitalized with medical illnesses: increased vulnerability with age. J Am Geriatr Soc 51:451–458. https://doi.org/10.1046/j.1532-5415.2003.51152.x

    Article  PubMed  Google Scholar 

  3. Gill TM, Allore HG, Gahbauer EA, Murphy TE (2010) Change in disability after hospitalization or restricted activity in older persons. JAMA 304:1919–1928. https://doi.org/10.1001/jama.2010.1568

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B (2012) Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet 380:37–43. https://doi.org/10.1016/S0140-6736(12)60240-2

    Article  PubMed  Google Scholar 

  5. Tan WJ, Chew MH, Tan IBH, Law JH, Zhao R, Acharyya S, Mao YL, Fernandez LG, Loi CT, Tang CL (2016) Palliative surgical intervention in metastatic colorectal carcinoma: a prospective analysis of quality of life. Colorectal Dis 18:357–363. https://doi.org/10.1111/codi.13142

    Article  CAS  PubMed  Google Scholar 

  6. Montroni I, Ugolini G, Saur NM, Rostoft S, Spinelli A, Van Leeuwen BL, De Liguori Carino N, Ghignone F, Jaklitsch MT, Somasundar P, Garutti A, Zingaretti C, Foca F, Vertogen B, Nanni O, Wexner SD, Audisio RA (2022) Quality of life in older adults after major cancer surgery: the GOSAFE international study. JNCI J Natl Cancer Inst 114:969–978. https://doi.org/10.1093/jnci/djac071

    Article  PubMed  Google Scholar 

  7. Outlaw D, Williams GR (2020) Is the lack of evidence in older adults with cancer compromising safety? Expert Opin Drug Saf 19:1059–1061. https://doi.org/10.1080/14740338.2020.1805429

    Article  PubMed  PubMed Central  Google Scholar 

  8. Nagashima F, Furuse J (2022) Treatments for elderly cancer patients and reforms to social security systems in Japan. Int J Clin Oncol 27:310–315. https://doi.org/10.1007/s10147-021-02099-0

    Article  PubMed  PubMed Central  Google Scholar 

  9. Fukata S, Ando M, Amemiya T, Kuroiwa K, Oda K (2012) Postoperative function following radical surgery in gastric and colorectal cancer patients over 80 years of age–an objection to “ageism.” Nagoya J Med Sci 74:241–251

    PubMed  PubMed Central  Google Scholar 

  10. Chou MY, Nishita Y, Nakagawa T, Tange C, Tomida M, Shimokata H, Otsuka R, Chen LK, Arai H (2019) Role of gait speed and grip strength in predicting 10-year cognitive decline among community-dwelling older people. BMC Geriatr 19:186. https://doi.org/10.1186/s12877-019-1199-7

    Article  PubMed  PubMed Central  Google Scholar 

  11. Reiss J, Iglseder B, Alzner R, Mayr-Pirker B, Pirich C, Kässmann H, Kreutzer M, Dovjak P, Reiter R (2019) Sarcopenia and osteoporosis are interrelated in geriatric inpatients. Z Gerontol Geriatr 52:688–693. https://doi.org/10.1007/s00391-019-01553-z

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Morishima T, Sato A, Nakata K, Matsumoto Y, Koeda N, Shimada H, Maruhama T, Matsuki D, Miyashiro I (2021) Barthel Index-based functional status as a prognostic factor in young and middle-aged adults with newly diagnosed gastric, colorectal and lung cancer: a multicentre retrospective cohort study. BMJ Open 11:e046681. https://doi.org/10.1136/bmjopen-2020-046681

  13. Quintana JM, Gonzalez N, Anton-Ladislao A, Redondo M, Bare M, Fernandez de Larrea N, Briones E, Escobar A, Sarasqueta C, Garcia-Gutierrez S, Aguirre U (2016) Colorectal cancer health services research study protocol: the CCR-CARESS observational prospective cohort project. BMC Cancer 16:435. https://doi.org/10.1186/s12885-016-2475-y

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Fukuhara S, Bito S, Green J, Hsiao A, Kurokawa K (1998) Translation, adaptation, and validation of the SF-36 health survey for use in Japan. J Clin Epidemiol 51:1037–1044. https://doi.org/10.1016/s0895-4356(98)00095-x

    Article  CAS  PubMed  Google Scholar 

  15. Fukuhara S, Ware JE Jr, Kosinski M, Wada S, Gandek B (1998) Psychometric and clinical tests of validity of the Japanese SF-36 health survey. J Clin Epidemiol 51:1045–1053. https://doi.org/10.1016/s0895-4356(98)00096-1

    Article  CAS  PubMed  Google Scholar 

  16. Suzukamo Y, Fukuhara S, Green J, Kosinski M, Gandek B, Ware JE (2011) Validation testing of a three-component model of Short Form-36 scores. J Clin Epidemiol 64:301–308. https://doi.org/10.1016/j.jclinepi.2010.04.017

    Article  PubMed  Google Scholar 

  17. Ohya H, Watanabe J, Suwa Y, Suwa H, Ozawa M, Ishibe A, Fujii S, Kubota K, Kunisaki C, Endo I (2020) The comparison of health-related quality of life and patient satisfaction between single-incision and multiport laparoscopic colectomy for cancer: a sub-study of a randomized, prospective clinical trial. Ann Gastroenterol Surg 4:684–692. https://doi.org/10.1002/ags3.12378

    Article  PubMed  PubMed Central  Google Scholar 

  18. Cabilan CJ, Hines S (2017) The short-term impact of colorectal cancer treatment on physical activity, functional status and quality of life a systematic review. JBI Database System Rev Implement Rep 15:517–566. https://doi.org/10.11124/JBISRIR-2016003282

    Article  CAS  PubMed  Google Scholar 

  19. Amemiya T, Oda K, Ando M, Kawamura T, Kitagawa Y, Okawa Y, Yasui A, Ike H, Shimada H, Kuroiwa K, Nimura Y, Fukata S (2007) Activities of daily living and quality of life of elderly patients after elective surgery for gastric and colorectal cancers. Ann Surg 246:222–228. https://doi.org/10.1097/SLA.0b013e3180caa3fb

    Article  PubMed  PubMed Central  Google Scholar 

  20. Shahrokni A, Alexander K (2019) The age of talking about age alone is over. Ann Surg Oncol 26:12–14. https://doi.org/10.1245/s10434-018-6983-7

    Article  PubMed  Google Scholar 

  21. Valeikaite-Tauginiene G, Kraujelyte A, Poskus E, Jotautas V, Saladzinskas Z, Tamelis A, Lizdenis P, Dulskas A, Samalavicius NE, Strupas K, Poškus T (2022) Predictors of quality of life six years after curative colorectal cancer surgery: results of the prospective multicenter study. Medicina (Kaunas) 58:482. https://doi.org/10.3390/medicina58040482

    Article  PubMed  Google Scholar 

  22. Wheelwright S, Permyakova NV, Calman L, Din A, Fenlon D, Richardson A, Sodergren S, Smith PWF, Winter J, Foster C (2020) Does quality of life return to pre-treatment levels five years after curative intent surgery for colorectal cancer? Evidence from the ColoREctal Wellbeing (CREW) study. PLOS ONE 15:e0231332. https://doi.org/10.1371/journal.pone.0231332

  23. Kazama K, Aoyama T, Hayashi T, Yamada T, Numata M, Amano S, Kamiya M, Sato T, Yoshikawa T, Shiozawa M, Oshima T, Yukawa N, Rino Y, Masuda M (2017) Evaluation of short-term outcomes of laparoscopic-assisted surgery for colorectal cancer in elderly patients aged over 75 years old: a multi-institutional study (YSURG1401). BMC Surgery 17:29. https://doi.org/10.1186/s12893-017-0229-7

  24. Grailey K, Markar SR, Karthikesalingam A, Aboud R, Ziprin P, Faiz O (2013) Laparoscopic versus open colorectal resection in the elderly population. Surg Endosc 27:19–30. https://doi.org/10.1007/s00464-012-2414-1

    Article  PubMed  Google Scholar 

  25. Sujatha-Bhaskar S, Alizadeh RF, Inaba CS, Koh CY, Jafari MD, Mills SD, Carmichael JC, Stamos MJ, Pigazzi A (2018) Respiratory complications after colonic procedures in chronic obstructive pulmonary disease: does laparoscopy offer a benefit? Surg Endosc 32:1280–1285. https://doi.org/10.1007/s00464-017-5805-5

    Article  PubMed  Google Scholar 

  26. Santa Mina D, van Rooijen SJ, Minnella EM, Alibhai SMH, Brahmbhatt P, Dalton SO, Gillis C, Grocott MPW, Howell D, Randall IM, Sabiston CM, Silver JK, Slooter G, West M, Jack S, Carli F (2021) Multiphasic prehabilitation across the cancer continuum: a narrative review and conceptual framework. Front Oncol 10:598425. https://doi.org/10.3389/fonc.2020.598425

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Funding

No funding was received for conducting this study.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, 7-45‑1 Nanakuma, Jonan‑ku, Fukuoka, 814-0180, Japan

    Toshifumi Watanabe, Ryo Ohno, Ryuji Kajitani, Kurumi Sahara, Taro Munechika, Yoshiko Matsumoto, Naoya Aisu, Daibo Kojima, Gumpei Yoshimatsu & Suguru Hasegawa

Authors
  1. Toshifumi Watanabe
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  2. Ryo Ohno
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  3. Ryuji Kajitani
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  4. Kurumi Sahara
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  5. Taro Munechika
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  6. Yoshiko Matsumoto
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  7. Naoya Aisu
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  8. Daibo Kojima
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  9. Gumpei Yoshimatsu
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  10. Suguru Hasegawa
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Contributions

All authors contributed to the study’s conception and design. Material preparation, data collection, and analysis were performed by Ryo Ohno, Ryuji Kajitani, Taro Munechika, Yoshiko Matsumoto. The first draft of the manuscript was written by Toshifumi Watanabe, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Toshifumi Watanabe.

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Ethics approval

The authors certify that the study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. This study was approved by the Fukuoka University Hospital Ethics Committee.

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Informed consent was obtained from all individual participants included in the study.

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Watanabe, T., Ohno, R., Kajitani, R. et al. Comparison of changes in health-related quality of life between elderly and non-elderly patients undergoing elective surgery for colorectal cancer. Int J Colorectal Dis 38, 149 (2023). https://doi.org/10.1007/s00384-023-04440-7

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