ANZ journal of surgery · 2026
A Pragmatic Real-World Observational Study of Patient Reported Outcome Measures (PROMs) Following Treatment of Colorectal Cancer-What Matters Most?
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Bhalla Tanya, Flynn James, Bhalla Anuj, Louden Elizabeth, Deans Andrew, Mohamed Usama, Rao Pawan Kumar Dhruva
Аннотация
PURPOSE: Patient reported outcome measures (PROMs) following colorectal cancer (CRC) treatment have been gaining prominence in addition to oncological outcomes. We have integrated PROMs collection through our nurse-led follow-up (NLFU) clinic of patients undergoing surgical/endoscopic treatment of CRC and report our real-world results.
METHODS: PROMs were collected using the EORTC 29 Questionnaire using a pre-appointment link via NLFU clinic over a period of 18 months since April 2023. The reported outcomes were analysed and correlated with patient demographics, tumour stage, type of procedure and duration since procedure.
RESULTS: Tumour site did not influence functional (FS) or symptom (SS) scores. Age demonstrated selective effects: older patients reported better overall functional outcomes but worse urinary-frequency symptoms. Gender did not significantly affect FS or SS. Symptomatic presentation was associated with higher symptom burden, particularly abdominal pain, buttock pain and urinary frequency, while FS remained comparable to screen-detected cases. Most operative approaches produced similar PROMs; however, body image, faecal incontinence and embarrassment differed between specific procedures. Neoadjuvant chemotherapy and tumour stage showed no significant relationships with FS or SS outcomes. Symptom trajectories improved over time, with stool frequency, urinary incontinence, body image and male sexual function varying significantly across follow-up durations, while FS remained stable. Sphincter preservation versus resection revealed worse body image, male sexual function and buttock pain in patients undergoing Abdominoperineal resections (APR). Organ preservation and surgical resection showed broadly comparable PROMs despite differing symptom patterns.
CONCLUSION: PROMs collection is feasible, and outcomes are largely stable across treatments, though symptom burden varies with patient and procedural factors.
METHODS: PROMs were collected using the EORTC 29 Questionnaire using a pre-appointment link via NLFU clinic over a period of 18 months since April 2023. The reported outcomes were analysed and correlated with patient demographics, tumour stage, type of procedure and duration since procedure.
RESULTS: Tumour site did not influence functional (FS) or symptom (SS) scores. Age demonstrated selective effects: older patients reported better overall functional outcomes but worse urinary-frequency symptoms. Gender did not significantly affect FS or SS. Symptomatic presentation was associated with higher symptom burden, particularly abdominal pain, buttock pain and urinary frequency, while FS remained comparable to screen-detected cases. Most operative approaches produced similar PROMs; however, body image, faecal incontinence and embarrassment differed between specific procedures. Neoadjuvant chemotherapy and tumour stage showed no significant relationships with FS or SS outcomes. Symptom trajectories improved over time, with stool frequency, urinary incontinence, body image and male sexual function varying significantly across follow-up durations, while FS remained stable. Sphincter preservation versus resection revealed worse body image, male sexual function and buttock pain in patients undergoing Abdominoperineal resections (APR). Organ preservation and surgical resection showed broadly comparable PROMs despite differing symptom patterns.
CONCLUSION: PROMs collection is feasible, and outcomes are largely stable across treatments, though symptom burden varies with patient and procedural factors.