New design-specific measure to assess quality of life in patients with recurrent rectal cancer

A new study produces the first disease-specific, psychometrically robust and validated measure of quality life for patients with locally recurrent rectal cancer.

This collaborative study between researchers in the UK and Australia is a huge step towards aligning outcome reporting with patient priorities in advanced cancer settings. The study, published in the journal eClinical Medicine (The Lancet Discovery Science), details the development, testing and analysis of this design-specific measure to assess quality of life in patients with recurrent rectal cancer, regardless of treatment intent.

This new measure - called the LRRC-QoL - consists of nine multi-item scales (healthcare services, psychological impact, pain, urostomy-related symptoms, lower limb symptoms, stoma, sexual interest, and urinary symptoms) and three single items. This captures and assesses the wide-ranging nature of issues which affect patients with locally recurrent rectal cancer, reflecting the complex and varied nature of the disease and its' management.

The LRRC-QoL is currently validated in the UK and Australia and available for uptake and adoption by clinicians, healthcare professionals and researchers for clinical and academic practice. There is ongoing work to develop the measure for further international use.

The management of locally recurrent rectal cancer, has undergone an evolution over the last decade, leading to significant clinical and oncological improvement. Along with these advancements there is growing recognition that health-related quality of life also needs to be appropriately measured with integrated reporting in this patient population.

Due to the lack of disease-specific, validated patient-reported outcome measures, health-related quality of life has been variably assessed in the past. The LRRC-QoL will provide broader based patient-centered, contextual relevance to clinical and oncological outcomes such as morbidity, recovery, and survival. It will help incorporate patient priorities into clinical practice and research, with equal value being placed on overall survival and maintaining quality of life."

Deena Harji, Lead Author, Associate Professor, Institute of Clinical Trials Research at the University of Leeds

Co-author Professor Michael Solomon from the Surgical Outcomes Research Centre at Royal Prince Alfred Hospital Sydney Australia said: "The LRRC-QoL has the potential to transform outcome assessment in locally recurrent rectal cancer. In clinical practice, the LRRC-QoL will be able to quantify patient symptoms, experience and overall satisfaction. This will lead to the disclosure and identification of potential issues not routinely reported and will aid the early detection and subsequent monitoring of symptoms."

Locally recurrent rectal cancer is a complex clinical entity, affecting a considerable proportion of patients worldwide. In 2020 there were 1,931,590 global colorectal cancer cases. A third of these cases were rectal cancer with locally recurrent rectal cancer affecting 5-10% of patients following a previous resection of rectal cancer. With treatments for locally recurrent rectal cancer often requiring invasive procedures with significant side effects, the LRRC-QoL is a timely and important tool for use in clinical and academic settings.

The study 'Development and validation of a patient reported outcome measure for health-related quality of life for locally recurrent rectal cancer: a multicentre, three-phase, mixed-methods, cohort study' will be published in the journal of eClinical Medicine (Lancet Discovery Science) on the 18 May 2023. (DOI: 10.1016/j.edinm.2023.101945)