Colon Cancer HRQoL No Worse With Adjuvant Chemotherapy Than Surgery Alone

Adjuvant chemotherapy does not adversely affect health-related quality of life in either young or elderly colon cancer patients

medwireNews: Health-related quality of life (HRQoL) and disease-specific symptoms are comparable between colon cancer patients treated with surgery plus adjuvant chemotherapy and those who receive surgery alone, a Dutch team reports.

Researcher Simone Verhaar, from TweeSteden Hospital in Tilburg, and co-workers note that this was the case in both younger and older patients, adding that there seems to be “no good reason” for withholding adjuvant chemotherapy for colon cancer patients of all agesbased on concerns for HRQoL or disease-specific symptoms.

Using the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire version 3.0 and the EORTC QLQ-colorectal 38 to measure HRQoL and disease-specific HRQoL, respectively, the researchers found no significant difference between the 282 patients who received surgery plus adjuvant chemotherapy and the 388 patients who received only surgery in the under 70 years age group.

Similarly, in the 70 years and older age group, the 211 patients who received surgery plus adjuvant chemotherapy and the 643 treated with surgery alone had comparable scores on all scales of both questionnaires. There was also no significant difference when colon cancer patients in this age bracket were compared with a normative sample of 98 cancer-free individuals matched for age and gender.

But for those younger than 70 years, fatigue, insomnia, diarrhoea and financial problems were reported significantly more frequently by patients with colon cancer, irrespective of the treatment received, than by the 587 individuals in the age- and gender-matched normative population. Moreover, compared with the normative sample, patients in the surgery only group had a significantly higher incidence of nausea and/or vomiting, appetite loss and constipation, while those who received adjuvant chemotherapy reported significantly more dyspnoea.

Simone Verhaar et al point out that most previous studies report an age-related decline in HRQoL in elderly colorectal cancer patients, a decline potentially paralleled in the general healthy population, which they say could explain why “HRQoL in elderly patientsdid not differ from the normative sample.”

Noting that several trials have shown significant improvements in disease-free and overall survival with adjuvant chemotherapy, the researchers conclude in the European Journal of Cancer that “it is important to treat patients with [adjuvant chemotherapy] when there is an indication.”


Verhaar S, Vissers PAJ, Maas H, et al.Treatment-related differences in health related quality of life and disease specific symptoms among colon cancer survivors: Results from the population-based PROFILES registry. EurJ Cancer; Advance online publication 4 May 2015.

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