caa a22 4500 445333979 CHVBK 20180317142747.0 cr unu---uuuuu 170323e20110901xx s 000 0 eng 10.1245/s10434-011-1650-2 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1650-2 Long-Term Follow-Up and Individual Item Analysis of Quality of Life Assessments Related to Laparoscopic-Assisted Colectomy in the COST Trial 93-46-53 (INT 0146) [Elektronische Daten] [Chee-Chee Stucky, Barbara Pockaj, Paul Novotny, Jeff Sloan, Daniel Sargent, Michael O'Connell, Robert Beart, John Skibber, Heidi Nelson, Jane Weeks] Background: Postoperative outcomes of patients undergoing laparoscopic-assisted colectomy (LAC) have shown modest improvements in recovery but only minimal differences in quality of life (QOL) compared with open colectomy. We therefore sought to assess the effect of LAC on QOL in the short and long term, using individual item analysis of multi-item QOL assessments. Methods: QOL variables were analyzed in 449 randomized patients from the COST trial 93-46-53 (INT 0146). Both cross-sectional single-time and change from baseline assessments were run at day 2, week 2, month 2, and month 18 postoperatively in an intention-to-treat analysis using Wilcoxon rank-sum tests. Stepwise regression models were used to determine predictors of QOL. Results: Of 449 colon cancer patients, 230 underwent LAC and 219 underwent open colectomy. Subdomain analysis revealed a clinically moderate improvement from baseline for LAC in total QOL index at 18months (P=0.02) as well as other small symptomatic improvements. Poor preoperative QOL as indicated by a rating scale of ≤50 was an independent predictor of poor QOL at 2months postoperatively. QOL variables related to survival were baseline support (P=0.001) and baseline outlook (P=0.01). Conclusions: Eighteen months after surgery, any differences in quality of life between patients randomized to LAC or open colectomy favored LAC. However, the magnitude of the benefits was small. Patients with poor preoperative QOL appear to be at higher risk for difficult postoperative courses, and may be candidates for enhanced ancillary services to address their particular needs. Society of Surgical Oncology, 2011 Stucky Chee-Chee Department of Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA aut Pockaj Barbara Department of Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA aut Novotny Paul Department of Biostatistics, Mayo Clinic, Rochester, MN, USA aut Sloan Jeff Department of Biostatistics, Mayo Clinic, Rochester, MN, USA aut Sargent Daniel Department of Biostatistics, Mayo Clinic, Rochester, MN, USA aut O'Connell Michael National Surgical Adjuvant Breast and Bowel Project Operations Center, Pittsburgh, PA, USA aut Beart Robert Department of Surgery, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA aut Skibber John Department of Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut Nelson Heidi Department of Surgery, Mayo Clinic, Rochester, MN, USA aut Weeks Jane Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA aut Annals of Surgical Oncology Springer-Verlag 18/9(2011-09-01), 2422-2431 1068-9265 18:9<2422 2011 18 10434 https://doi.org/10.1245/s10434-011-1650-2 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1650-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Stucky Chee-Chee Department of Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA aut NATIONALLICENCE 700 1- Pockaj Barbara Department of Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA aut NATIONALLICENCE 700 1- Novotny Paul Department of Biostatistics, Mayo Clinic, Rochester, MN, USA aut NATIONALLICENCE 700 1- Sloan Jeff Department of Biostatistics, Mayo Clinic, Rochester, MN, USA aut NATIONALLICENCE 700 1- Sargent Daniel Department of Biostatistics, Mayo Clinic, Rochester, MN, USA aut NATIONALLICENCE 700 1- O'Connell Michael National Surgical Adjuvant Breast and Bowel Project Operations Center, Pittsburgh, PA, USA aut NATIONALLICENCE 700 1- Beart Robert Department of Surgery, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA aut NATIONALLICENCE 700 1- Skibber John Department of Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut NATIONALLICENCE 700 1- Nelson Heidi Department of Surgery, Mayo Clinic, Rochester, MN, USA aut NATIONALLICENCE 700 1- Weeks Jane Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/9(2011-09-01), 2422-2431 1068-9265 18:9<2422 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer