Effect of age factors on health-related quality of life in patients with lower rectal cancer after sphincter-saving surgery: A 1-year longitudinal study

Purpose: To examine age-related factors influencing health-related quality of life (HR-QOL) among patients with lower rectal cancer during the 12-month period after sphincter-saving surgery (SSS). Material and methods: In this 1-year longitudinal study, 137 patients (120 patients completed, and 82 aged >= 60 years) answered the European Organization for Research and Treatment of Cancer questionnaire (EORTC-C30/CR38) assessing their HR-QOL and related factors during the 12 months after SSS. Results: No significant differences in HR-QOL were found before surgery. Only among those aged >= 60 years, global health status/QOL and cognitive functioning showed a significant decrease one month after surgery. At one month after SSS, the role functioning of groups < 60 years old (which is negatively related to defecation problems, insomnia, and financial difficulties) was lower compared to those aged >= 60 years; and role functioning was significantly related to global health status/QOL. Six months after SSS, the global health status/QOL had recovered. In both groups, global health status/QOL was related to role and social functioning. Among participants aged < 60 years, global health status/QOL was significantly related to emotional functioning, which is related to future perspective. Among participants aged >= 60 years only, global health status/QOL was significantly related to cognitive functioning; pain, financial difficulties, and defecation problems negatively influenced HR-QOL. Symptoms specific after SSS: defecation problems (in both group), micturition problems (only >= 60 years), and sexual problems (only < 60 years) influenced HR-QOL. Conclusion: Health care providers should assess the influence of age-related factors during the early post-operative period after SSS to improve HR-QOL.