Evaluation of short-term quality of life changes after surgery in elderly patients with colorectal cancer using the Medical Outcomes Study short form (MOS-SF-36) questionnaire

Background: Elderly patients with colorectal cancer (CRC) commonly present a reduction of their quality of life (QoL) before surgery when compared to younger patients. However, the QoL changes following surgical resection between groups of age are rarely considered. The short-form (SF-36) of the Medical Outcomes Study (MOS) questionnaire has long been used in clinical practice for healthy policy evaluation and patient population survey. It is a 36-item questionnaire with eight scaled sections: a lower score corresponds to a more disease-related disability. The aim of the present study was to evaluate the postoperative health-related QoL between elderly and young patients after conservative surgical resection for Stage I-II CRC, evaluated using the MOS-SF-36 questionnaire. Methods: A group of 72 patients with confirmed Stage I-II (Dukes A-B) colonic adenocarcinoma requiring conservative surgery were prospectively enrolled in the study. There were 49 (68.1%) elderly (>65 years) and 23 (31.9%) nonelderly patients. Informed consent was obtained from each participant. In both groups, preoperative physical and mental QoL were lower than in the reference healthy populations. After successful surgical resection, the day before discharge all patients were asked to report their functional limitations and health-related status by filling the following sections of the MOS-SF-36 (No. of items): bodily pain (2), emotional role functioning (3), general health perceptions (5), mental health (5), physical functioning (10), physical role functioning (4), social role functioning (2), vitality (4). Mann-Whitney U-test was used to compare results. A p-value <0.05 was considered statistically significant. Results: The results are reported in the Table. In general, the health-related QoF after surgery was similar in both groups. However, the evaluation of bodily pain (65.3±20.2 vs. 52.3±18.2, p=0.01) and vitality (61.3±18.9 vs. 52.4±17.1, p=0.03) reported by younger patients was higher than that reported by elderly patients. Conclusions: The elderly seem to be more sensitive to physical pain and to feel a reduced vitality after surgery than younger patients, probably because they are worried by the problems that will occur after discharge. A more careful psychological support should be organized for these patients.