Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

From a Clustering of Adverse Symptoms After Colorectal Cancer Therapy to Chronic Fatigue and Low Ability to Work: A Cohort Study Analysis With 3 Months of Follow-Up

Tomislav Vlaski
ORCID logo ,
Marija Slavic
,
Reiner Caspari
,
Bettine Bilsing
,
Harald Fischer
,
Hermann Brenner
ORCID logo ,
Ben Schöttker
* ORCID logo
Version 1 : Received: 30 November 2023 / Approved: 1 December 2023 / Online: 1 December 2023 (03:33:02 CET)

A peer-reviewed article of this Preprint also exists.

Vlaski, T.; Slavic, M.; Caspari, R.; Bilsing, B.; Fischer, H.; Brenner, H.; Schöttker, B. From a Clustering of Adverse Symptoms after Colorectal Cancer Therapy to Chronic Fatigue and Low Ability to Work: A Cohort Study Analysis with 3 Months of Follow-Up. Cancers 2024, 16, 202. Vlaski, T.; Slavic, M.; Caspari, R.; Bilsing, B.; Fischer, H.; Brenner, H.; Schöttker, B. From a Clustering of Adverse Symptoms after Colorectal Cancer Therapy to Chronic Fatigue and Low Ability to Work: A Cohort Study Analysis with 3 Months of Follow-Up. Cancers 2024, 16, 202.

Abstract

In colorectal cancer (CRC) patients, apart from fatigue, psychological and physical symptoms often converge, affecting their quality of life and ability to work. Our objective was to ascertain symptom clusters within a year following CRC treatment and their longitudinal association with persistent fatigue and reduced work ability at the 3-month follow-up. We used data from MIRANDA, a multicenter cohort study enrolling adult CRC patients who are starting a 3-week in-patient rehabilitation within a year post-curative CRC treatment. Participants completed questionnaires evaluating symptoms at the start of rehabilitation (baseline) and after three months. We performed an exploratory factor analysis to analyze the clustering of symptoms at baseline. Longitudinal analysis was performed using a multivariable linear regression model with dichotomized symptoms at baseline as independent variables, and the change of fatigue and ability to work from baseline to 3-month-follow-up as separate outcomes, adjusted for covariates. We identified six symptom clusters: fatigue, gastrointestinal symptoms, pain, psychosocial symptoms, urinary symptoms, and chemotherapy side effects. At least one symptom from each factor was associated with higher fatigue or reduced ability to work at the 3-month follow-up. This study highlights the interplay of multiple symptoms in influencing fatigue and work ability among CRC patients post rehabilitation.

Keywords

colorectal cancer; rehabilitation; fatigue; ability to work; symptom clusters

Subject

Medicine and Pharmacology, Oncology and Oncogenics

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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