B. L. Den Oudsten

Sexual (dys)function and the quality of sexual life in patients with colorectal cancer: a systematic review

BACKGROUND To determine (i) the prevalence of sexual (dys)function in patients with colorectal cancer and (ii) treatment-related and sociodemographic aspects in relation to sexual (dys)function and the quality of sexual life. Recommendations for future studies are provided. METHODS A systematic search was conducted during the period 1990 to July 2010 that used the databases PubMed, PsychINFO, The Cochrane Library, EMBASE, and OVID Medline. RESULTS Eighty-two studies were included. The mean quality score was 7.2. The percentage of preoperatively potent men that experienced sexual dysfunction postoperatively varied from 5% to 88%. Approximately half of the women reported sexual dysfunction. Preoperative radiotherapy, a stoma, complications during or after surgery, and a higher age predicted more sexual dysfunction with a strong level of evidence. Type of surgery and a lower tumor location predicted more sexual dysfunction with a moderate level of evidence. Insufficient evidence existed for predictors of the quality of sexual life. Current studies mainly focus on biological aspects of sexual (dys)function. Furthermore, existing studies suffer from methodological shortcomings such as a cross-sectional design, a small sample size, and the use of nonstandardized measurements. CONCLUSIONS Sexuality should be investigated prospectively from a biopsychosocial model, hereby including the quality of sexual life.BACKGROUND To determine (i) the prevalence of sexual (dys)function in patients with colorectal cancer and (ii) treatment-related and sociodemographic aspects in relation to sexual (dys)function and the quality of sexual life. Recommendations for future studies are provided. METHODS A systematic search was conducted during the period 1990 to July 2010 that used the databases PubMed, PsychINFO, The Cochrane Library, EMBASE, and OVID Medline. RESULTS Eighty-two studies were included. The mean quality score was 7.2. The percentage of preoperatively potent men that experienced sexual dysfunction postoperatively varied from 5% to 88%. Approximately half of the women reported sexual dysfunction. Preoperative radiotherapy, a stoma, complications during or after surgery, and a higher age predicted more sexual dysfunction with a strong level of evidence. Type of surgery and a lower tumor location predicted more sexual dysfunction with a moderate level of evidence. Insufficient evidence existed for predictors of the quality of sexual life. Current studies mainly focus on biological aspects of sexual (dys)function. Furthermore, existing studies suffer from methodological shortcomings such as a cross-sectional design, a small sample size, and the use of nonstandardized measurements. CONCLUSION Sexuality should be investigated prospectively from a biopsychosocial model, hereby including the quality of sexual life.

Psychometric and screening properties of the WHO‐5 well‐being index in adult outpatients with Type 1 or Type 2 diabetes mellitus

The 5‐item World Health Organization well‐being index is a commonly used measure of emotional well‐being, but research on psychometric properties in outpatients with diabetes is scarce. We examined psychometric and screening properties for depression of this index in a large sample of Dutch outpatients with diabetes.

Higher prevalence of sexual dysfunction in colon and rectal cancer survivors compared with the normative population: A population-based study

BACKGROUND To compare colorectal cancer survivors with a normative population regarding erectile dysfunction, ejaculation problems, dyspareunia, dry vagina, sexual functioning (SF) and enjoyment (SE). In addition, the sociodemographic, clinical and psychological correlates of (dys)function in survivors are examined. PATIENTS AND METHODS The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-CR38 sexuality subscales were completed by survivors (n=1371; response rate 82%), of which 1359 received surgical treatment and were included in the analysis. The normative population consisted of 400 participants (response rate 78%). RESULTS Erectile problems were more often present in rectal cancer (54%) than colon cancer survivors (25%) and the normative population (27%; p<.0001). They also had more ejaculation problems (68%) than colon cancer survivors (47%; p<.001). Dry vagina was common in colon (28%) and rectal cancer survivors (35%), while the normative population scored lower (5%; p=.003). In addition, colon (9%) and rectal cancer survivors (30%) experienced more pain during intercourse than the normative population (0%; p=.001). SE for men was similar across groups, while women with colorectal cancer reported lower scores than the normative population. Higher age, being a woman, not having a partner, a low educational level, rectal cancer, depressive symptoms and fatigue were associated with lower SF. Lower SE was associated with higher age and being a woman, depressive symptoms and cardiovascular disease. CONCLUSION SF was deteriorated in both sexes after cancer, which affected womens SE negatively. Attention towards sexual (dys)function in colorectal cancer survivors is needed.

Health status, health-related quality of life, and quality of life following ankle fractures: A systematic review

INTRODUCTION The number of disabling short- and long-term consequences after ankle fracture (AF) is high. Therefore, it is important to consider the health status (HS), health-related quality of life (HRQOL), and quality of life (QOL) of these patients. The aim of this study was to provide a systematic overview of studies on HS, HRQOL, and QOL in patients with AF. In addition, the conceptualisation of HS, HRQOL, and QOL in these studies was evaluated. METHODS A systematic literature search was conducted in Pubmed, Embase, The Cochrane Library, and PsycINFO (January 1976 to April 2012). RESULTS Twenty-three studies were included of which almost half had a cross-sectional design. The assessment of HRQOL or QOL was an explicit objective in 17.4% of the studies. The SF-36 and SMFA were the instruments most often used and measure respectively HS and a combination of HS and HRQOL. However, they had been labelled as functional status. Inconclusive results were reported regarding the predictive value of age, sex, education level, alcohol use, smoking, fracture type, and the role of syndesmotic reduction with regard to HS and HRQOL. Also, inconclusive results were found comparing HS and HRQOL scores of patients with AF with norm population scores and regarding the course of HS and HRQOL over time. The additional value of early mobilisation after AF was not confirmed. CONCLUSIONS There are few quality studies on HS and HRQOL following AF and results are inconclusive. Future studies should measure these important patient-reported outcomes, including QOL. The concepts HS and HRQOL are not applied in agreement with the content of the instruments and instruments are downgraded to assess functional status. The correct terminology should be used to warrant clear communication in the field.

Prospective multicentre cohort study of patient-reported outcomes after cholecystectomy for uncomplicated symptomatic cholecystolithiasis

Up to 33 per cent of patients with uncomplicated symptomatic cholecystolithiasis report persistent pain after cholecystectomy. The aim of this study was to determine characteristics associated with patient‐reported absence of abdominal pain after cholecystectomy, improved abdominal symptoms, and patient‐reported positive cholecystectomy results in a prospective cohort multicentre study.

Evaluation of long-term function, complications, quality of life and health status after restorative proctocolectomy with ileo neo rectal and with ileal pouch anal anastomosis for ulcerative colitis

Restorative surgery after (procto)colectomy with ileo‐neorectal anastomosis (INRA) or restorative proctocolectomy with ileal pouch anal anastomosis (RPC) combines cure of ulcerative colitis (UC) with restoration of intestinal continuity. This study aimed to evaluate these two operations.

Reliability and validity of the Cancer Therapy Satisfaction Questionnaire in lung cancer

PurposeTo test the reliability and validity of the Cancer Treatment Satisfaction Questionnaire (CTSQ), to assess its relation with quality of life (QoL), and to assess the interpretability of the domain scores in lung cancer patients receiving intravenous chemotherapy.MethodsPatients with stage IIIB and IV non-squamous non-small cell lung carcinoma treated with pemetrexed were enrolled in our study. They completed the 16-item CTSQ and two other (health-related) QoL questionnaires. Information about sociodemographic characteristics, cancer stage, and the experience of adverse events was collected. Internal consistency, construct validity, and clinical interpretability were calculated.ResultsFifty-five patients completed the CTSQ. Correlations of the CTSQ items with its domain were all above 0.40. A high correlation between item 8 and the expectations of therapy and satisfaction with therapy domain was observed (0.50 and 0.48, respectively). The CTSQ domains demonstrated good internal consistency and low to moderate correlations of the CTSQ with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 and World Health Organization Quality of Life-BREF. No significant differences in mean domain scores were observed in relation to the number and severity of different adverse events and chemotherapy-related adverse events.ConclusionsThe Dutch version of the CTSQ was found to be a reliable and valid instrument to assess satisfaction and expectations of treatment in lung cancer patients receiving intravenous chemotherapy. Furthermore, the CTSQ proved to be of additional informative value as not all of its domains correlated with the various domains of the existing HRQoL instruments.

Written information material and availability of sexual health care for men experiencing sexual dysfunction after prostate cancer treatment: An evaluation of Dutch urology and radiotherapy departments

Objective was to investigate content of written information material and availability of sexual health care for men experiencing sexual dysfunction (SD) after prostate cancer treatment. A cross-sectional survey was conducted among Dutch urology and radiotherapy departments to evaluate information materials and availability of sexual health care. Out of 71 eligible departments, 34 urology and 15 radiotherapy departments participated in the survey (response rate 69.0%). Fifty-nine brochures corresponding to 31 urology and 11 radiotherapy departments were analysed. In 88.1% of collected information material, sexual health was mentioned. Regarding extensiveness, 20.4% of the brochures contained extensive information, 50.8% moderate amount of information and 28.8% contained little or no information. Urology departments provided pre-treatment nurse consultations more often than radiotherapy departments. Sexual counselling was more frequently provided by urology departments. Urology departments were more aware of adequate referral possibilities. Information material provided by Dutch urology and radiotherapy departments does not address treatment-related SD routinely. Sexual health care is not available everywhere for men experiencing SD. Applying a standard regarding content of sexual health in information material is recommended as well as improved awareness of referral possibilities and enhanced provision of pre-treatment nurse consultations for men experiencing SD after prostate cancer treatment.

160P: Depressive symptoms, performance score, and personality traits as predictors of (health related) quality of life in patients with advanced stage lung cancer

whereas CT showed a high specificity (Table 1). PET parameters (max and peak SUV) reached a significant AUC to predict RECIST analysis. Conclusions: The higher number of PET responders combined with the higher AUC values compared to CT indicates that PET is able to predict treatment response earlier than CT, though typically at a lower specificity. The next step will be to define the optimal thresholds for better response prediction including the combination of PET-based and CT-based criteria together with clinical variables. Clinical trial identification: NCT01171170 Legal entity responsible for the study: A.-M. C. Dingemans Funding: Dutch Cancer Society Disclosure: All authors have declared no conflicts of interest.

187P: Patient's feelings about side-effects are predictive for (Health Related) Quality of Life in patients with advanced stage lung cancer treated with chemotherapy

different from frontline therapy. We analyzed safety and tolerability as well as number of Bev cycles given to these cohort. Results: Nine pts received C/P/Bev and 3 pts received C/Pem/Bev followed by maintenance (MTX) Bev. Median age was 77 years old (range, 75–82); 9 (75%) pts were female; all pts had adenocarcinoma histology. Most common AEs were: fatigue (n = 4), vomiting (n = 2), and diarrhea (n = 2). Only one pt stopped Bev due to SAEs (hypertensive crisis); no embolic events, nephrotic syndrome, gastrointestinal perforation, fistula perforation, RPLS, and serious hemorrhage were found. Median cycles of MTX Bev was 4.5 (range, 0–28); median total of Bev cycles including induction was 9.5 (range, 1–32). Median progression-free survival (PFS) was 7.1 months. Conclusions: In our 12 pts older than 75 years old, we did not find major SAEs secondary to Bev but 1 pt. Our pts had good ECOG PS and 8 pts (75%) had 1 comorbid condition. Median PFS was similar to that reported in the literature when Bev has been combined with platinum-based doublet followed by MTX. With a detailed clinical history and careful assessment, our experience indicates that Bev can be offered to elderly pts older than 75 years old. Legal entity responsible for the study: Lynn Cancer Institute Research Department Funding: Lynn Cancer Institute Research Department Disclosure: E.S. Santos: Speaker Bureau: Genentech, Lilly US Oncology. All other authors have declared no conflicts of interest.