This cross-sectional study used data from the Dutch Prospective PLCRC cohort, including patients with stage I-III colon cancer who completed patient-reported outcome measures (PROMs) at 12 or 24 months post-diagnosis. HRQoL was assessed using EORTC QLQ-C30, QLQ-CR29 and the LARS score. Patients diagnosed in 2014-2016 (Group A) were compared with those from 2017 to 2019 (Group B). Propensity score matching (1:4) was applied for age, sex and tumour stage. Multivariable analyses were adjusted accordingly, minimally important differences (MIDs) guided clinical relevance and the values were compared with Dutch population values.
Dutch colon cancer patients reported good HRQoL and functional outcomes up to 2 years post-diagnosis, with no clinically relevant differences between 2014-2016 and 2017-2019. These findings suggest a consistently high standard of care nationwide. Ongoing monitoring remains essential to address individual symptom burden and evaluate the impact of evolving treatment strategies.
A total of 1,749 patients were included in the analysis. Following propensity score matching, no clinically meaningful differences in the EORTC QLQ-C30 functional or symptom scales were observed at 12 months post-diagnosis between patients diagnosed in 2014-2016 (Group A) and those diagnosed in 2017-2019 (Group B). At 24 months, Group B demonstrated a modestly better QLQ-C30 summary score (mean difference + 1.3; 95% CI: 0.6-1.9), as well as statistically significant but clinically negligible improvements in role and cognitive functioning, and lower reported levels of fatigue, appetite loss and financial difficulties. Functional outcomes assessed via QLQ-CR29 and LARS score were comparable between groups, with a non-significant trend towards fewer major LARS cases in Group B at 24 months (14.6% vs. 19.9%; p = 0.068).
Colon cancer treatment has evolved significantly through earlier detection, less invasive surgery, optimised perioperative care and shortening chemotherapy duration from 6 to 3 months in 2017. These multidisciplinary improvements may contribute to better health-related quality of life (HRQoL), yet population-based data on their real-world impact on HRQoL and functional outcomes remain limited.
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