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Purpose Quality of life in colorectal cancer patients may be affected by colostomy and treatment, but relevant studies are still scarce and contradictory. The present study aimed to evaluate the association between colostomy time and treatment type with quality of life in colorectal cancer patients. Methods A prospective observational study of 41 patients with colorectal cancer was conducted on three occasions T0, T1 and T2 (0–2; 3–5 and 6–8 months after ostomy surgery, respectively). The treatments prescribed were: surgery alone, chemotherapy or radiotherapy, or chemoradiotherapy. European Organization for Research and Treatment of Cancer questionnaires were used to evaluate quality of life. Worsening clinical changes were evaluated considering difference in scores between times of surgery ≥±9 points. Results Regarding ostomy surgery, scores in physical function improved between T0 and T1 and these better scores were maintained at T1 to T2. The same was observed for urinary frequency, appetite loss and dry mouth. Chemoradiotherapy was associated with worse scores for global health status, nausea and vomiting, bloating and dry mouth. Although significant differences were not observed in some domains in the Generalized Estimating Equations analysis, patients showed noticeable changes for the worse in the pain, anxiety, weight concern, flatulence and embarrassment domains during these periods. Conclusions Colostomy improved quality of life at 3–5 months in most domains of quality of life and remained better at 6–8 months after surgery. Chemoradiotherapy had a late negative influence on quality of life. Health teams could use these results to reassure patients that this procedure will improve their quality of life in many functional and symptomatic aspects.

Pesquisa sem auxílio de agências de fomento Introdução: A colostomia e tratamento quimiorradioterápico podem afetar a qualidade de vida (QV) em pacientes com câncer colorretal (CCR). Ainda são raros e contraditórios os estudos que investigam o impacto da estomia e o tipo de tratamento na QV em pacientes colostomizados devido ao CCR. Objetivo: Avaliar a associação dos tempos de colostomia e do tipo de tratamento com a QV após cirurgia de estomia, bem como investigar modificações clinicamente significativas nos escores dos domínios de QV ao longo do tempo. Métodos: Foi realizado um estudo prospectivo com 46 pacientes colostomizados devido ao CCR em três momentos: T0, no qual foram incluídos pacientes com cirurgia recente de colostomia (0-2 meses); T1 (3-5 meses após a cirurgia); e T2 (6-8 meses após a cirurgia). Os tipos de tratamento foram: cirurgia isolada, quimioterapia ou radioterapia e quimiorradioterapia. Os escores de QV foram estimados a partir dos Questionários da European Organization for Research and Treatment of Cancer, EORTC-QLQ30 e EORTC-QLQ-CR29. A equação de estimativa generalizada (EEG) foi utilizada para avaliar a associação do tempo de colostomia e do tipo de tratamento nos domínios de QV. Para as alterações negativas e clinicamente significativas foi calculada a diferença entre os escores por tempo. E o delta ≥ ±9 nos escores por tempo foi estimado através do tamanho de efeito multiplicado pelo desvio padrão da amostra, considerando o escore do estado global de saúde. Resultados: A amostra foi composta por 53,7% do sexo feminino, 63,4% de idosos e em 51,2% foi realizada quimiorradioterapia. A estomia foi associada à melhores escores de QV de T0 a T1 e mantiveram essa melhora entre T1 a T2 em diversos domínios funcionais e de sintomas, tais como: função física, perda de apetite, frequência urinária e boca seca. Por outro lado, a quimiorradioterapia foi associada à piores escores para alguns domínios como estado global de saúde, náusea e vômito, dor, sangue e muco nas fezes, barriga inchada e boca seca. Mesmo que em alguns domínios não tenham mostrado resultado significativo nas EEG, os pacientes apresentaram modificações negativas e clinicamente significativas em diversos domínios como dor, ansiedade, preocupação com o peso, flatulência e constrangimento entre os tempos. Conclusão: A colostomia melhorou a QV em 3-5 meses na maioria dos domínios e manteve essa melhora em 6-8 meses após a cirurgia. Por outro lado, a quimiorradioterapia associou-se à piores escores na QV mesmo após 6-8 meses do tratamento. Portanto, as equipes de saúde podem conscientizar os pacientes que a cirurgia de estomia melhora a QV em muitos aspectos funcionais e de sintomas, trazendo mais conforto aos pacientes nessa condição. Introduction: Colostomy and chemoradiotherapy treatment may affect the quality of life (QoL) in patients with colorectal cancer (CRC). There are still scarce and contradictory studies that investigate the impact ostomy and the type of treatment on QoL, with colostomized patients due to CRC. Objective: To assess the association of colostomy times and type of treatment with QoL after ostomy surgery, as well as evaluate the clinically important difference on QoL domain score changes between times. Methods: A prospective observational study was conducted with 46 patients with CRC on three occasions: T0, which included patients with recent colostomy surgery (0-2 months); T1 (3-5 months after surgery); and T2 (6-8 months after surgery). Treatment types were: surgery alone, chemotherapy or radiotherapy, and chemoradiotherapy. European Cancer Research and Treatment Organization EORTC-QLQ30 and EORTC-QLQ-CR29 questionnaires were used to assess QoL. The generalized estimation equation (GEE) was used to assess the association of colostomy time and type of treatment on QoL. For the clinically significant negative changes, the difference between the scores by time was calculated. Delta ≥ ±9 in the scores for time was estimated through the effect size multiplied by the standard deviation of the sample, considering the score of the global health status. Results: The sample consisted of 53.7% female, 63.4% elderly and chemoradiotherapy was performed in 51.2% of the patients. The ostomy was associated with better T0 to T1 QoL scores and maintained this improvement between T1 to T2 in several functional and symptom domains, such as physical function, loss of appetite, urinary frequency and dry mouth. On the other hand, chemoradiotherapy was associated with worse scores for some domains such as global health status, nausea and vomiting, pain, blood and mucus in the stool, bloating and dry mouth. Even though not observed significant differences in some domains in GEE analysis, the patients had clinically significant negative modifications in various domains such as pain, anxiety, weight concern, flatulence and embarrassement in times. Conclusion: Colostomy improved QoL at 3-5 months in most domains and remained better at 6-8 months after surgery. Still, chemoradiotherapy was associated with worse QoL scores even after 6-8 months of treatment. Therefore, the health teams can make patients aware that ostomy surgery improves QoL in many functional and symptom aspects, bringing more comfort to patients in this condition. Dissertação (Mestrado) 2024-02-14