University of Oulu

Lehtomäki K, Stedt HP, Osterlund E, Muhonen T, Soveri L-M, Halonen P, Salminen TK, Kononen J, Kallio R, Ålgars A, Heervä E, Lamminmäki A, Uutela A, Nordin A, Lehto J, Saarto T, Sintonen H, Kellokumpu-Lehtinen P-L, Ristamäki R, Glimelius B, Isoniemi H, Osterlund P. 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. Cancers. 2022; 14(7):1713.

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

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Author: Lehtomäki, Kaisa1,2; Stedt, Hanna P.3,4; Osterlund, Emerik5;
Organizations: 1Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön Katu 34, 33520 Tampere, Finland
2Department of Oncology, Tays Cancer Centre, Tampere University Hospital, Teiskontie 35, 33520 Tampere, Finland
3Department of Oncology, Kuopio University Hospital, Puijonlaaksontie 2, 70210 Kuopio, Finland
4Faculty of Health Sciences, University of Eastern Finland, Yliopistonranta 1A, 70210 Kuopio, Finland
5Department of Immunology, Genetics and Pathology, Uppsala University, Rudbecklaboratoriet, Dag Hammarskjölds Väg 20, 75185 Uppsala, Sweden
6Department of Oncology, South Carelia Central Hospital, Valto Käkelän Katu 1, 53130 Lappeenranta, Finland
7Home Care, Joint Municipal Authority for Health Care and Social Services in Keski-Uusimaa, Sairaalakatu 1, 05850 Hyvinkää, Finland
8Department of Oncology, University of Helsinki, Haartmaninkatu 8, 00290 Helsinki, Finland
9Department of Oncology, Helsinki University Hospital, Haartmaninkatu 4, 00290 Helsinki, Finland
10Department of Oncology, Central Finland Central Hospital, Keskussairaalantie 19, 40620 Jyväskylä, Finland
11Docrates Cancer Centre, Docrates Hospital, Saukonpaadenranta 2, 00180 Helsinki, Finland
12Department of Oncology, Oulu University Hospital, Kajaanintie 50, 90220 Oulu, Finland
13Department of Oncology, University of Oulu, Pentti Kaiteran Katu 1, 90570 Oulu, Finland
14Department of Oncology, Turku University Hospital, Hämeentie 11, 20520 Turku, Finland
15Department of Oncology, University of Turku, Kiinanmyllynkatu 10, 20520 Turku, Finland
16Department of Transplantation and Liver Surgery, Abdominal Centre, Helsinki University Hospital, Haartmaninkatu 4, 00290 Helsinki, Finland
17Department of Surgery, University of Helsinki, Haartmaninkatu 8, 00290 Helsinki, Finland
18Palliative Care Centre, Tampere University Hospital, Teiskontie 35, 33520 Tampere, Finland
19Department of Palliative Care, Comprehensive Cancer Centre, Helsinki University Hospital, Haartmaninkatu 4, 00290 Helsinki, Finland
20Department of Public Health, University of Helsinki, Tukholmankatu 8B, 00290 Helsinki, Finland
21Department of Gastrointestinal Oncology, Tema Cancer, Karolinska Universitetssjukhuset, Eugeniavägen 3, 17176 Solna, Sweden
22Department of Oncology-Pathology, Karolinska Institutet, Solnavägen 1, 17177 Solna, Sweden
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.8 MB)
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Language: English
Published: Multidisciplinary Digital Publishing Institute, 2022
Publish Date: 2022-09-07


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-cross-sectional 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 tumour-controlling 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.

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Series: Cancers
ISSN: 2072-6694
ISSN-E: 2072-6694
ISSN-L: 2072-6694
Volume: 14
Issue: 7
Article number: 1713
DOI: 10.3390/cancers14071713
Type of Publication: A1 Journal article – refereed
Field of Science: 3122 Cancers
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.
Copyright information: © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (