ABSTRACT
Introducción: la calidad de vida de pacientes con cáncer varía según el estadio clínico de la enfermedad, siendo peor en estadios avanzados. Métodos: estudio prospectivo en el que se evaluaron 317 pacientes con cáncer colorrectal o gástrico que asistieron al Instituto Nacional de Cancerología durante los años 2010 y 2011 y que no habían iniciado tratamiento. Se utilizó el cuestionario EORTC QLQ C-30, un instrumento que mide calidad de vida en 15 dominios. Se compararon las puntuaciones para cada dominio según el estadio tumoral. Adicionalmente se realizó un análisis de funcionamiento diferencial de ítems para establecer si las diferencias encontradas correspondían a propiedades del instrumento o de la muestra de pacientes. Resultados: 145 pacientes (45,7%) tuvieron diagnóstico de cáncer de colon. Dependiendo del estadio clínico se encontraron diferencias en los niveles de calidad de vida solo en tres de los 15 dominios (funcionamiento físico, funcionamiento social y anorexia). Las principales diferencias en los dominios del constructo dependieron de la localización del tumor (los pacientes con cáncer colorrectal presentaron mejor calidad de vida) y del sexo (las mujeres reportaron mejor calidad de vida). Las diferencias encontradas no parecieron depender de propiedades de los ítems. Los ítems que exploran el constructo de manera general y no específica fueron los que mejor midieron la calidad de vida en este grupo de pacientes. Conclusión: en este grupo de pacientes con cáncer gástrico y colorrectal los niveles de calidad de vida se relacionaron más con la localización del tumor que con el estadio clínico(AU)
Background: previous studies with patients having cancer have shown that quality of life scores depend on the clinical stage of the disease (the more advanced the disease, the worst quality of life). Methods: in a prospective study we studied 317 patients with gastric or colorectal cancer attending the Instituto Nacional de Cancerología between 2010 and 2011; the patients completed the EORTC QLQ-C30 before receiving treatment. This instrument measures quality of life in 15 domains. Scores of each domain were compared according to tumor stage. Differential Item Functioning was measured across neoplasm staging and tumor localization. Results: 145 patients (45.7%) were diagnosed with colorectal cancer. According to clinical staging, differences in quality of life scores were observed in 4 of 15 domains (physical and social functioning, anorexia). Most of the differences in quality of life domains depended on tumor localization (patients with colorectal cancer had the highest scores in quality of life) and sex (women reported better scores). These differences seemed to be independent of item properties. The construct was more adequately measured with items that explore the construct using a general approach. Conclusion: in this group of patients with colorectal and gastric cancer quality of life scores were more related with tumor localization than with clinical stage(AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Quality of Life , Gastrointestinal Neoplasms/epidemiology , Gastrointestinal Neoplasms/rehabilitation , Outcome and Process Assessment, Health Care/organization & administration , Outcome and Process Assessment, Health Care/standards , Prospective Studies , Surveys and Questionnaires , Multivariate AnalysisABSTRACT
BACKGROUND: previous studies with patients having cancer have shown that quality of life scores depend on the clinical stage of the disease (the more advanced the disease, the worst quality of life). METHODS: in a prospective study we studied 317 patients with gastric or colorectal cancer attending the Instituto Nacional de Cancerología between 2010 and 2011; the patients completed the EORTC QLQ-C30 before receiving treatment. This instrument measures quality of life in 15 domains. Scores of each domain were compared according to tumor stage. Differential Item Functioning was measured across neoplasm staging and tumor localization. RESULTS: 145 patients (45.7%) were diagnosed with colorectal cancer. According to clinical staging, differences in quality of life scores were observed in 4 of 15 domains (physical and social functioning, anorexia). Most of the differences in quality of life domains depended on tumor localization (patients with colorectal cancer had the highest scores in quality of life) and sex (women reported better scores). These differences seemed to be independent of item properties. The construct was more adequately measured with items that explore the construct using a general approach. CONCLUSION: in this group of patients with colorectal and gastric cancer quality of life scores were more related with tumor localization than with clinical stage.