Quality of Life Outcomes in Patients with Anal Cancer After Combined Radiochemotherapy

Purpose: To assess self-reported quality of life (QoL) experienced by anal cancer patients after radiochemotherapy, and to identify patient- and disease-related factors associated with QoL.

Patients And Methods: A total of 88 patients treated for anal cancer at our institution between 1990 and 2006 were identified from our database. Of these, 15 patients had died, and 4 were lost to follow-up. QoL was assessed using the EORTC QLQ-C30 questionnaire (cancer-specific QoL) and the colorectal cancer module QLQ-CR38 (site-specific QoL); 52 responses were received. The median follow-up was 36 months (range, 5-137 months).

Results: As for cancer-specific QoL, global health QoL score (mean 60.4) was similar to the general German population, whereas most of the function and symptom scale scores were considerably lower/higher in anal cancer patients. The most prominent mean score differences were observed in role functioning (-21.8 points), emotional functioning (-20.7 points), social functioning (-28.9 points), diarrhea (+34.6 points), and financial difficulties (+26.9 points; p < 0.001). As for site-specific QoL, the mean function scale scores ranged from 22.1 (sexual function) to 63.2 (body image), and the mean symptom scale scores from 14.7 (weight loss) to 69.0 (stoma-related problems, 4 patients) and 67.9 (male sexual dysfunction), respectively. Most of the QoL scores were not affected by late toxicity, patient- or disease-related factors. Fatigue (+18.2 points) emerged as the strongest predictor of impaired QoL.

Conclusion: The global health QoL of anal cancer patients is comparable with that of the general German population, but there are specific limitations, e.g., sexual dysfunction, urological/gastrointestinal complaints, financial difficulties, fatigue, and a reduction in emotional and social well-being.