Validation of the chinese version of the EORTC QLQ-CR29 in patients with colorectal cancer

doi:10.3748/wjg.v23.i10.1891

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Mar 14, 2017; 23(10): 1891-1898
Published online Mar 14, 2017. doi: 10.3748/wjg.v23.i10.1891

Table 1 Sociodemographic and clinical characteristics of the patients (n = 356) n (%)

Characteristics	No. of patients¹
Age (yr, mean ± SD)	54.5 ± 13.5
Sex	341²
Male	213 (62.5)
Female	128 (37.5)
Educational status	341²
Junior high school	182 (53.4)
Senior high school	107 (31.4)
University	47 (13.8)
Postgraduate and above	5 (1.5)
Marital status	340²
Single	5 (1.5)
Married	334 (98.2)
Divorced	1 (0.3)
Employment	343²
Yes	268 (78.1)
No	75 (21.9)
Location of tumor	342²
Colon	193 (56.4)
Rectum	147 (43.0)
Both	2 (0.6)
Metastasis	343²
Yes	102 (29.7)
No	215 (62.7)
Unknown	26 (7.6)
Time from first diagnosis (wk) Median (interquartile range)	16.0 (33.8)

¹All percentages are valid;

²There are missing data.

Table 2 Item convergent and discriminant validity for the EORTC QLQ-CR29 scales, and for patients with and without a stoma

QLQ-CR29 scales	Total sample (n = 354)¹			Without a stoma (n = 298)			With a stoma (n = 56)
QLQ-CR29 scales	Convergent	Discriminant	α	Convergent	Discriminant	α	Convergent	Discriminant	α
Urinary frequency	0.589-0.923	0.004-0.306	0.406	0.588-0.924	0.002-0.321	0.363	0.587-0.919	0.017-0.333	0.608
Blood or mucus in stools	0.794-0.886	0.004-0.712	0.641	0.790-0.891	0.002-0.738	0.638	0.815-0.829	0.037-1.000	0.632
Stool frequency	0.689-0.965	0.003-0.641	0.679	0.696-0.967	0.001-0.669	0.716	0.645-0.957	0.003-0.389	0.423
Body image	0.628-0.826	0.060-0.405	0.715	0.614-0.839	0.039-0.422	0.718	0.703-0.792	0.004-0.504	0.676

¹Two are missing.

Table 3 Correlations between the EORTC QLQ-CR29 and the QLQ-C30

	EORTC-QLQ-C30
	QOL	PF	RF	EF	CF	SF	FA	NV	PA	DY	SL	AP	CO	DI	FI
CR29 scales
Urinary frequency	0.004	-0.071	-0.111^a	-0.083	-0.163^b	-0.159^b	0.107^a	-0.130^a	-0.033	-0.046	0.061	0.023	-0.131^a	-0.022	0.063
Blood and mucus in stool	-0.412^b	-0.320^b	-0.074	-0.091	-0.166^b	0.077	0.296^b	0.383^b	0.451^b	0.166^b	0.190^b	0.120^a	0.321^b	0.526^b	-0.141^a
Stool frequency	-0.322^b	-0.236^b	-0.075	-0.132^a	-0.115^a	-0.026	0.268^b	0.340^b	0.349^b	0.212^b	0.188^b	0.120^a	0.247^b	0.492^b	-0.113^a
Body image	0.254^b	0.179^b	-0.052	0.051	0.100	-0.172^b	-0.303^b	-0.485^b	-0.363^b	-0.251^b	-0.185^b	-0.279^b	-0.240^b	-0.224^b	0.132^a
CR29 single items
Urinary incontinence	0.084	0.040	0.237^b	0.203^b	-0.071	0.171^b	-0.038	0.270^b	0.125^a	0.311^b	0.080	0.040	0.135^a	0.139^b	-0.291^b
Dysuria	0.032	0.101	0.223^b	0.210^b	-0.185^b	0.288^b	0.053	0.330^b	0.272^b	0.296^b	0.133^a	0.003	0.279^b	0.158^b	-0.294^b
Abdominal pain	-0.357^b	-0.399^b	-0.149^b	-0.086	-0.245^b	0.097	0.411^b	0.342^b	0.648^b	0.321^b	0.307^b	0.241^b	0.375^b	0.381^b	-0.118^a
Buttock pain	-0.114^a	-0.105	0.129^a	0.056	-0.138^a	0.271^b	0.131^a	0.487^b	0.343^b	0.224^b	0.178^b	0.139^b	0.278^b	0.160^b	-0.273^b
Bloating	-0.261^b	-0.233^b	-0.277^b	-0.302^b	-0.129^a	-0.206^b	0.213^b	0.080	0.240^b	0.130^a	0.221^b	0.183^b	0.207^b	0.252^b	0.125^a
Dry mouth	-0.117^a	-0.074	0.181^b	0.120^a	-0.104	0.216^b	0.152^b	0.321^b	0.262^b	0.358^b	0.134^a	0.110^a	0.218^b	0.122^a	-0.163^b
Hair loss	-0.112^a	-0.085	0.167^b	0.037	-0.131^a	0.222^b	0.184^b	0.486^b	0.286^b	0.276^b	0.108^a	0.127^a	0.232^b	0.155^b	-0.200^b
Taste	-0.218^b	-0.238^b	-0.214^b	-0.278^b	-0.222^b	-0.107^a	0.266^b	0.137^a	0.102	0.088	0.294^b	0.459^b	0.013	0.163^b	0.083
Anxiety	-0.233^b	-0.147^b	-0.425^b	-0.547^b	-0.033	-0.412^b	0.150^b	-0.272^b	-0.103	-0.095	0.011	0.134^a	-0.089	0.066	0.449^b
Weight	-0.217^b	-0.266^b	-0.346^b	-0.371^b	-0.175^b	-0.244^b	0.287^b	0.042	0.103	0.026	0.202^b	0.287^b	0.005	0.184^b	0.306^b
Flatulence	-0.057	-0.094	0.170^b	0.039	-0.115^a	0.159^b	0.092	0.433^b	0.206^b	0.180^b	0.106^a	0.180^b	0.200^b	0.236^b	-0.166^b
Fecal incontinence	-0.017	-0.032	0.275^b	0.218^b	-0.129^a	0.320^b	0.049	0.447^b	0.284^b	0.252^b	0.163^b	0.055	0.229^b	0.257^b	-0.350^b
Sore skin	-0.052	-0.132^a	0.208^b	0.170^b	-0.094	0.296^b	0.081	0.497^b	0.205^b	0.130^a	0.160^b	0.123^a	0.106^a	0.194^b	-0.271^b
Embarrassment	-0.049	-0.041	0.200^b	0.085	-0.019	0.209^b	0.036	0.317^b	0.167^b	-0.006	0.027	0.059	0.070	0.088	-0.209^b
Stoma care problems	-0.184	0.210	0.224	-0.254	0.044	0.064	-0.025	0.019	-0.033	-0.265	-0.059	0.007	-0.161	0.073	0.175
Sexual interest (men)	-0.108	-0.177^a	-0.051	0.041	-0.276^b	-0.184^b	0.142^a	-0.089	0.051	0.119	0.112	0.004	-0.010	0.039	0.092
Impotence	-0.026	-0.102	0.189^b	0.177^a	-0.212^b	0.243^b	0.105	0.242^b	0.082	0.155^a	0.175^a	0.157^a	0.069	0.093	-0.256^b
Sexual interest (women)	-0.319^b	-0.213^a	-0.092	0.030	-0.386^b	-0.006	0.091	-0.099	0.044	0.194	0.270^b	0.056	0.176	-0.010	0.215^a
Dyspareunia	0.026	0.003	0.213^b	0.322^b	-0.129	0.258^b	-0.094	0.423^b	0.185	0.227^a	0.005	0.090	0.312^b	0.117	-0.193

^aP < 0.05,

^bP < 0.01, EORTC QLQ-CR29 vs the QLQ-C30. QOL: Quality of life; PF: Physical functioning; RF: Role functioning; EF: Emotional functioning; CF: Cognitive functioning; SF: Social functioning; FA: Fatigue; NV: Nausea/vomiting; PA: Pain; DY: Dyspnea; SL: Insomnia; AP: Appetite loss; CO: Constipation; DI: Diarrhea; FI: Financial problems.

Table 4 Known group comparisons: scales and items in the QLQ-C30 and CR29 for clinically distinct groups

	Stoma (n = 56)	No stoma (n = 298)	P value¹	KPS ≤ 80(n = 162)	KPS > 80(n = 177)	P value¹
CR29 scales
Urinary frequency	6.5 ± 14.5	6.1 ± 13.5	0.856	6.7 ± 12.3	5.8 ± 14.9	0.098
Blood and mucus in stool	18.9 ± 25.9	10.3 ± 16.3	0.160	13.8 ± 19.7	7.3 ± 12.7	0.019
Stool frequency	8.0 ± 13.2	8.4 ± 14.8	0.960	11.2 ± 18.2	5.1 ± 9.6	0.017
Body image	81.7 ± 18.9	88.6 ± 14.7	0.004	87.7 ± 17.7	89.0 ± 11.9	0.589
CR29 single items
Urinary incontinence	7.7 ± 4.2	1.6 ± 7.1	< 0.001	0.8 ± 0.7	4.2 ± 11.1	0.001
Dysuria	7.7 ± 16.8	5.4 ± 12.3	0.444	3.2 ± 11.2	8.0 ± 14.7	< 0.001
Abdominal pain	11.9 ± 21.5	12.0 ± 18.7	0.651	13.5 ± 21.0	9.0 ± 16.1	0.059
Buttock pain	10.7 ± 15.7	5.4 ± 13.2	0.005	2.5 ± 8.8	9.0 ± 16.1	< 0.001
Bloating	16.1 ± 16.8	20.9 ± 21.4	0.183	25.2 ± 23.9	15.0 ± 16.6	< 0.001
Dry mouth	11.9 ± 17.3	7.2 ± 15.1	0.025	6.0 ± 14.4	8.0 ± 15.1	0.170
Hair loss	14.3 ± 18.9	9.6 ± 16.6	0.058	7.7 ± 17.2	11.1 ± 16.2	0.010
Taste	15.5 ± 22.9	23.8 ± 21.7	0.002	26.0 ± 25.0	18.8 ± 18.4	0.015
Anxiety	31.0 ± 31.0	44.6 ± 23.7	< 0.001	52.1 ± 22.6	35.1 ± 24.1	< 0.001
Weight	22.6 ± 21.2	44.6 ± 23.7	0.032	32.3 ± 19.9	21.6 ± 16.8	< 0.001
Flatulence	14.3 ± 17.8	5.0 ± 13.4	< 0.001	4.5 ± 14.6	7.0 ± 13.6	0.012
Fecal incontinence	15.5 ± 20.1	4.4 ± 11.9	< 0.001	2.5 ± 10.2	8.0 ± 15.1	< 0.001
Sore skin	26.2 ± 23.5	3.1 ± 10.1	< 0.001	3.5 ± 12.7	9.7 ± 17.5	< 0.001
Embarrassment	25.0 ± 20.4	2.3 ± 8.4	< 0.001	4.1 ± 12.8	7.1 ± 14.6	0.019
Stoma care problems	/	/	/	18.8 ± 20.8	19.8 ± 25.2	0.941
Sexual interest (men)	74.4 ± 23.5	69.8 ± 25.5	0.333	76.3 ± 22.8	66.0 ± 26.0	0.020
Impotence	9.4 ± 17.0	8.5 ± 20.2	0.364	6.5 ± 19.2	10.7 ± 19.9	0.021
Sexual interest (women)	81.0 ± 17.8	77.1 ± 22.5	0.749	83.7 ± 16.8	71.2 ± 25.0	0.005
Dyspareunia	9.5 ± 16.3	4.3 ± 14.1	0.172	2.7 ± 15.0	6.5 ± 13.4	0.012
QLQ-C30 scales
Physical	85.5 ± 12.4	82.9 ± 16.5	0.335	77.6 ± 18.3	89.4 ± 10.7	< 0.001
Role	84.8 ± 17.2	69.4 ± 20.6	< 0.001	61.7 ± 20.6	81.2 ± 16.4	< 0.001
Emotional	80.5 ± 17.7	74.4 ± 14.0	0.001	69.3 ± 14.4	81.2 ± 11.9	< 0.001
Cognitive	79.5 ± 20.5	80.7 ± 20.0	0.397	75.4 ± 34.9	85.9 ± 14.6	< 0.001
Social	60.0 ± 22.4	45.7 ± 25.5	< 0.001	38.5 ± 24.9	55.7 ± 23.5	< 0.001
Overall quality of life	67.9 ± 21.4	67.8 ± 17.4	0.636	59.5 ± 16.5	76.4 ± 14.4	< 0.001
Fatigue	18.8 ± 18.2	22.8 ± 19.9	0.108	30.5 ± 20.3	13.2 ± 13.8	< 0.001
Nausea and vomiting	11.6 ± 13.8	6.1 ± 14.4	< 0.001	4.7 ± 15.7	8.1 ± 12.5	< 0.001
Pain	13.0 ± 16.6	12.0 ± 17.3	0.427	13.3 ± 19.1	9.4 ± 13.8	0.211

¹Wilcoxon rank sum test.

Citation: Lin JB, Zhang L, Wu DW, Xi ZH, Wang XJ, Lin YS, Fujiwara W, Tian JR, Wang M, Peng P, Guo A, Yang Z, Luo L, Jiang LY, Li QQ, Zhang XY, Zhang YF, Xu HW, Yang B, Li XL, Lei YX. Validation of the chinese version of the EORTC QLQ-CR29 in patients with colorectal cancer. World J Gastroenterol 2017; 23(10): 1891-1898
URL: https://www.wjgnet.com/1007-9327/full/v23/i10/1891.htm
DOI: https://dx.doi.org/10.3748/wjg.v23.i10.1891