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The original version of this article, unfortunately, contained errors.
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PURPOSE: Quality of life may predict survival. In addition to clinical variables, it may be influenced by psychological factors, some of which may be accessible for intervention. The primary objective of this study was to investigate the association of intrusive thoughts and the patients' sense of coherence with pretreatment quality of life in patients with newly diagnosed rectal cancer. METHODS: Patients were prospectively included in 16 hospitals in Sweden and Denmark. They answered an extensive questionnaire after receiving their treatment plan. Clinical data were retrieved from national quality registries for rectal cancer. RESULTS: Of 1248 included patients, a total of 1085 were evaluable. Pretreatment global health-related and overall quality of life was lower in patients planned for palliative compared with curative treatment (median 53 vs. 80 on the EuroQoL visual analogue scale, p < 0.001 and odds ratio 0.56, 95% confidence interval 0.36-0.88, respectively). Quality of life was associated with intrusive thoughts (odds ratio 0.33, 95% confidence interval 0.24-0.45) and sense of coherence (odds ratio 0.44, 95% confidence interval 0.37-0.52) irrespective of the treatment plan. CONCLUSIONS: Pretreatment quality of life was influenced by the intent of treatment as well as by intrusive thoughts and the patients' sense of coherence. Interventions could modify these psychological factors, and future studies should focus on initiatives to improve quality of life for this group of patients.
Asunto(s)
Estadificación de Neoplasias/psicología , Manejo de Atención al Paciente/métodos , Calidad de Vida , Neoplasias del Recto , Rumiación Cognitiva , Adulto , Anciano , Dinamarca , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cuidados Paliativos/psicología , Técnicas Psicológicas , Investigación Cualitativa , Neoplasias del Recto/patología , Neoplasias del Recto/psicología , Neoplasias del Recto/terapia , Suecia , Escala Visual AnalógicaRESUMEN
PURPOSE: It is well known that an increased body mass index (BMI) is associated with cancer development. Results from studies on colorectal cancer (CRC) treatment outcome and BMI are however conflicting. Our hypothesis was that a high as well as a low BMI will have negative effects on short-term outcome after CRC surgery. METHODS: Data from the Swedish Colorectal Cancer Registry from 2007 to 2012 was analyzed. A total of 24,587 patients operated on for CRC were included in the study and divided into one of five categories for BMI. Operative bleeding, operating time, surgical complications, and 30-day mortality were compared between groups. RESULTS: Operative bleeding as well as operating time was significantly increased when comparing normal-weight patients to overweight (p < 0.001). 15.1% of normal-weight patients suffered from postoperative surgical complications. This was significantly increased with each BMI step but did not affect the 30-day mortality. However, underweight patients, on the other hand, had fewer complications (13.3%) but an increased 30-day mortality. CONCLUSION: Longer operating times and increased perioperative bleeding may be explanatory factors behind increased postoperative complication rates for CRC patients with higher BMI. In underweight patients, advanced disease may be a reason for a higher 30-day mortality. To improve outcome, specific precautions are suggested when operating on under- as well as overweight CRC patients. We also suggest that the registry introduces a better marker than BMI for central visceral fat-the link between obesity and cancer development. Further studies are needed to analyze the findings in detail and to study long-term effects.