Background. Studies have shown an association between baseline quality of life (Qol) and survival in advanced cancers. The aim of this study was to investigate their predictive value in long term survival after elective colorectal cancer resection. Methods. A consecutive series of patients undergoing elective colorectal cancer surgery for nonmetastatic disease were recruited in 2003/04. Patients completed standardized quality of life questionnaires (HADS, FACTC, MRS, and PANAS) prior to and 6 weeks after surgery. Univariate (log-rank test) and multivariate analyses (Cox proportional hazards) were performed to predict long term survival. Results. Ninety-seven patients met the inclusion criteria. Sixty-five (67%) were male and the median age of the group was 70 years. Forty-six (47.5%) patients had died and the mean survival was 1,741 days (median 2159, range 9–2923 days). Preoperative mood rating scale and functional assessment of cancer therapy-colorectal FACT C emotional well-being and postoperative FACT C additional concerns were independent predictors of long term survival. Conclusion. Incorporating psychosocial measures in preoperative assessment of cancer patients could help to identify patients who require assessment with a view to implementing psychosocial interventions. These active interventions to maximize mood and well-being should form an integral part of multidisciplinary treatment in these patients. 1. Introduction Quality of life (Qol) is a critical aspect of living with cancer and there is increasing realization that beneficial and adverse changes in Qol are very important for patients and caregivers [1]. Qol measurements have become an integral part of cancer trials and the resultant available Qol data has shown a strong association between Qol and survival in cancer populations [2, 3]. Over the years, the quality of Qol data has also significantly improved allowing more meaningful analysis. Efficace et al. found a significant improvement in the quality and completeness of data and described over 60% of studies as being robust enough to guide clinical decision making [2, 4]. One of the earliest studies showing an association between quality of life and survival was published in 1987 and reported a significant relationship between changes in patient-rated well-being and survival in women receiving treatment for advanced breast cancer [5]. Similar results were published in 1991 in patients with metastatic lung cancer [6]. Numerous studies since then have reported the link between Qol and survival in varying cancers. Publications include
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