INTRODUCTIONThe impact of patient, disease, operative characteristics as well as perioperative health-related quality of life (HRQL) on early (6-week) post-operative HRQL was investigated in patients undergoing elective abdominal colorectal surgery. METHODSA single-institution prospective study evaluated HRQL of patients after elective colorectal surgery between May 2005-June 2006. The EORTC QLQ-C30 and the EORTC QLQ-CR38 were administered to 168 patients preoperatively, and at 2 and 6 weeks postoperatively (postop). Multivariate analyses assessed the impact of age, gender, surgical approach (laparoscopic vs. open), diagnosis (malignant vs. benign), presence of a stoma and perioperative (preoperative and 2-week postop) HRQL on the relevant functional scales and symptom scores of patients at 6-weeks postop.RESULTSMean age of the cohort was 56 years with 90(54%) men. Diagnosis was malignant in 35%. Laparoscopic surgery was performed in 57% and a stoma was required in 33%. Age, gender, surgical approach and presence of a stoma did not impact the measured functional scales and symptom scores at 6-weeks postop. Diagnosis (malignant vs. benign) adversely impacted global health (69 vs. 80), emotional (72 vs. 80), social functioning (66 vs. 77), body image (71 vs. 79), future perspective (53 vs. 68), chemotherapy side-effects (25 vs. 14), intestinal symptoms (24 vs. 16), and fatigue (45 vs. 32, p=0.003) scores. Preoperative HRQL was significantly associated with 6-week scores in global health, social functioning, chemotherapy side effects, gastrointestinal symptom. All scores measured at 2-weeks were significantly associated with scores at 6-weeks (Table)CONCLUSIONPatients undergoing elective colorectal resection who have cancer and adverse QOL during the perioperative period are at risk for poor QOL at 6 weeks postop. These patients should be offered appropriate support mechanisms to offset these adverse influences.
Multivariate analysis of factors influencing QOL at 6-weeks postoperatively

	Age		Cancer	Laparoscopic	Stoma	Perioperative
						Preop.	2-week
Global health	0.23	0.27	0.006	0.47	0.98	0.044	<0.001
Physical	0.19	0.60	0.69	0.62	0.37	0.31	<0.001
Role	0.98	0.14	0.10	0.14	0.11	0.63	<0.001
Emotional	0.57	0.28	0.017	0.88	0.05	0.39	<0.001
Cognitive	0.95	0.32	0.86	0.24	0.07	0.08	<0.001
Social	0.51	0.77	0.018	0.47	0.22	0.040	<0.001
Body image	0.49	0.27	0.035	0.49	0.20	0.21	<0.001
Fatigue	0.55	0.27	0.002	0.39	0.01	0.76	<0.001
Future perspective	0.12	0.63	0.004	0.85	0.74	0.81	<0.001
Chemotherapy side effects	0.58	0.29	0.001	0.64	0.15	0.001	<0.001
GI symptoms	0.60	0.96	0.003	0.29	0.25	<0.001	<0.001