Relationship Between Quality Of Life And TCM Syndrome Types In Patients With Colorectal Cancer After Colectomy

Background: Colorectal cancer is one of the most common forms of cancer. It is the third most commonly diagnosed cancer and the second leading cause of cancer death in the United States of America. In china, the incidence of colorectal cancer is increasing. In 2000, an estimated 146,000 new cases of colorectal cancer were diagnosed, and approximately 78, 700 people died of the disease. Surgical removal is the preferred treatment for colorectal cancer. Surgical treatment is indicated in nearly all patients with newly diagnosed cancer of the colorectum unless survival is unlikely or life expectancy is very short due to advanced cancer or other diseases. Frequently concerns arise about outcomes after surgery, and little is known about postoperative quality of life in these colorectal patients after colectomy. Quality of life associated with cancer and radiation treatment includes the dimensions of psychological and physical well-being, nutrition concerns/side effects, and radiation treatment-related anxiety/adjustment. Quality of life colorectal cancer is closely related to the clinical and pathological stage of the disease at diagnosis. Quality of life is an important outcome after surgery for colorectal cancer, and accurate assessment is essential in order to inform clinical decisions by providing insights into patients' experiences of the disease and treatment.Objective: To investigate how the quality of life of patients with colorectal cancer changes over time after colectomy, and explore the relationship between the syndrome types differentiated by traditional Chinese medicine and the quality of life in patients with colorectal cancer after colectomy.Methods: Patients in the case were identified from the colorectal cancer database at Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China. All had treatment for colorectal cancer within the last 4 years. Patients were surveyed by mail or telephone interview or spot investigation using the European Organization for Research and Treatment of Cancer quality of life questionnaire (EORTC QLQ-C30) and a colorectal specific European Organization for Research and Treatment of Cancer quality of life questionnaire (EORTC QLQ-CR38). Kruskal Wallis H test was used to test difference.Results: From Jan. 2004 to Dec. 2005, 142 patients with colorectal cancer were recruited in this retrospective, non-randomized study. There were 46 cases in stagnation of damp-heat group, 47 cases in qi-stagnancy and blood stasis group, and 49 cases in asdthenic splenonephro-yang group. The current average ages were 59.2±11.7, 62.6±11.2, and 64.8±12.4, respectively. Pearson chi-square test showed the cases in three groups had no statistical difference in terms of gender, surgical procedure and stage of cancer and pathology differentiated degree and adjuvant chemotherapy (P > 0.05). The three groups scored similarly on the EORTC QLQ-C30 and EORTC QLQ-CR38 in all domains except physical functioning, emotional functioning, and cognitive functioning and social functioning and micturation problems. The median scores of physical functioning, emotional functioning and cognitive functioning and social functioning domains in asdthenic splenonephro-yang group were lower than stagnation of damp-heat group and qi-stagnancy and blood stasis group.The differences among them were of statistical significance( P< 0.05), and of clinical significance (Variance of median scores > 10). Patients of stagnation of damp-heat group complained more micturation problems than asdthenic splenonephro-yang group and qi-stagnancy and blood stasis group, and qi-stagnancy and blood stasis group complained least about micturation problems. The only score with statistically significant difference was the global health status, role functioning and dyspnea and pain and defecation problems and gastrointestinal symptoms after surgical treatment. However, the difference was not of clinical significance.Conclusion: The variation of syndrome types could significantly influence physical function, emotional functioning and cognitive functioning and social functioning and micturation problems domains of quality of life, which provides important evidence for the further study of the quality of life.