• Christoph Kowalski, Nora Tabea Sibert, Clara Breidenbach, Anna Hagemeier, Rebecca Roth, Thomas Seufferlein, Stefan Benz, Stefan Post, Robert Siegel, Armin Wiegering, Raphael Winkels, Stefanie Bieck-Messemer, Jörg Fahlke, Christoph Reissfelder, Martin Fuchs, Torsten Herzog, Richard Weihrauch, Julia Faber-Mertens, Hagen Rudolph, László Puskás, Kay Kohlhaw, Malgorzata Szczerbinska, Hubert Scheuerlein, Philipp-Alexander Neumann, Stephan Hollerbach, Maren Riechmann, Ernst W Kolbe, Norbert Weigert, Jörg Köninger, Christian Klink, Shueb Mussa, Anja-Kathrin Horn, Ludger Staib, Jens Werner, Joachim Jähne, Mohamed Aly, Hubert Mörk, Robert Grützmann, Pompilio Piso, Sebastian Dieng, and Simone Wesselmann.
• Dtsch Arztebl Int. 2022 Dec 2; 119 (Forthcoming): 821828821-8.

BackgroundIn this observational study, patient-reported outcomes and short-term clinical outcome parameters in patients with colorectal cancer were studied 12 months after the start of treatment. Outcomes were also compared across German Certified Colorectal Cancer Centres.MethodsData were collected from 4239 patients with colorectal cancer who had undergone elective tumor resection in one of 102 colorectal cancer centers and had responded to a quality-of-life questionnaire before treatment (EORTC QLQ-C30 and -CR29). 3142 (74.1%) of these patients completed a post-treatment questionnaire 12 months later. Correlation analyses were calculated and case-mix adjusted comparisons across centers were made for selected patient-reported outcomes, anastomotic insufficiency, and 30-day-mortality.ResultsAt 12 months, mild improvements were seen in mean quality-of-life scores (66 vs. 62 points), constipation (16 vs. 19), and abdominal pain (15 vs. 17). Worsening was seen in physical function (75 vs. 82) and pain (22 vs. 19). Better patient-reported outcomes at 12 months were associated with better scores before treatment. Better results in at least three of the five scores were associated with male sex, higher educational level, higher age, and private health insurance. Major worsening of fecal incontinence was seen among patients with rectal cancer without a stoma. The largest differences across centers were found with respect to physical function. Anastomotic insufficiency was found in 4.3% of colon cancer patients and 8.2% of rectal cancer patients. 1.9% of patients died within 30 days after their resection.ConclusionClinicians can use these findings to identify patients at higher risk for poorer patient-reported outcomes. The differences among cancer centers that were found imply that measures for quality improvement would be desirable.

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