Key result
Frailty was independently associated with poor preoperative health-related quality of life in older patients with colorectal cancer (adjusted OR 1.53).
Why the study?
Colorectal cancer predominantly affects older adults whose outcomes may be influenced by baseline HRQoL, but predictors of poor preoperative HRQoL remained to be identified.
What are the predictors of poor preoperative health-related quality of life in older patients undergoing colorectal cancer surgery?
Cohort (n=179)
No
What are the predictors of poor preoperative health-related quality of life in older patients undergoing colorectal cancer surgery?
Odds Ratio: 1.53 (95% CI 1.01–2.43)
Absolute Event Rate: 60.7% vs 41.1%
p-value: p=0.042
Frailty, functional status, sex, and education level are key determinants of preoperative HRQoL in older patients with colorectal cancer, which can be used to stratify risk and target interventions.
May inform risk stratification before CRC surgery in older adults; leaves open whether HRQoL optimization alters outcomes.
Background Colorectal cancer (CRC) predominantly affects older adults, whose treatment outcomes may be influenced by baseline health-related quality of life (HRQoL). This study aimed to identify predictors of poor preoperative HRQoL in older patients undergoing CRC surgery and to stratify them into risk groups. Methods We retrospectively analyzed data on patients aged ≥65 years who underwent radical CRC surgery at a single medical center in Taiwan (2016-2018). Preoperative HRQoL was assessed using the EORTC QLQ-ELD14 questionnaire and a comprehensive geriatric assessment. Patients were stratified into high or low HRQoL groups based on the median QLQ-ELD14 sum score. Logistic regression identified independent predictors of poor HRQoL, and recursive partitioning analysis (RPA) was applied for risk stratification. Results Among the 179 patients, the most distressing HRQoL domains were Burden of Disease , Maintaining Purpose , and Worries about Others . Independent predictors of poor HRQoL included female sex (adjusted odds ratio [OR] = 2.41, P = 0.029), frailty (adjusted OR = 1.53, P = 0.042), poor Eastern Cooperative Oncology Group (ECOG) performance status (adjusted OR = 2.19, P = 0.008), and lower educational attainment (adjusted OR = 0.23, P = 0.019). RPA identified five patient subgroups with distinct risk levels; frail female had the highest risk (71.4%), while fit patients with college education or higher had the lowest (9.5%). Conclusion Frailty, functional status, sex, and education level are key determinants of preoperative HRQoL in older patients with CRC. The RPA provides a simple tool to identify high-risk patients, allowing targeted preoperative interventions to optimize care and enhance surgical outcomes.
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Lai et al. (2025) conducted a cohort in Colorectal cancer (n=179). Frailty vs. Fit status was evaluated on Poor preoperative health-related quality of life (QLQ-ELD14 sum score >125) (OR 1.53, 95% CI 1.01-2.43, p=0.042). Frailty was independently associated with poor preoperative health-related quality of life in older patients with colorectal cancer (adjusted OR 1.53).
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