The impact of chemotherapy on cognitive performance post-surgery in patients with colorectal cancer: A prospective cohort study

Marie Rose Dwek; Stanton P. Newman; Stefano Brini; Pru Holder; Michael Machesney; David Propper; Lorna R. Rixon; Shashivadan P. Hirani; Catherine S. Hurt

doi:10.1002/pon.6147

The impact of chemotherapy on cognitive performance post-surgery in patients with colorectal cancer: A prospective cohort study

Marie Rose Dwek, Stanton P. Newman, Stefano Brini, Pru Holder, Michael Machesney, David Propper, Lorna R. Rixon, Shashivadan P. Hirani, Catherine S. Hurt^*

^*Corresponding author for this work

Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation

Research output: Contribution to journal › Article › peer-review

2 Citations (Scopus)

Abstract

Objectives: Subjective reports of cognitive impairment following chemotherapy are frequent in cancer patients. Objective cognitive impairment has been observed in cancer patients regardless of treatment regimen suggesting the relationship between cognitive impairment and chemotherapy is not clear cut. Little research has explored the effects of chemotherapy on cognition following surgery in colorectal cancer (CRC). The present study explored the effects of chemotherapy on cognitive performance in a sample of CRC patients. Methods: 136 participants were recruited into a prospective cohort study: 78 CRC patients undergoing surgery and adjuvant chemotherapy, 58 CRC patients undergoing surgery only. A battery of neuropsychological tests was administered to participants 4 weeks post-surgery (T1), 12 weeks after first chemotherapy (T2) and 3 months after last chemotherapy (T3) or equivalent time-points. Results: Using the criterion of scoring at least two standard-deviations below the group norm on at least one neuropsychological test, 45%–55% of all CRC patients showed cognitive deficits 10 months after surgery (T3) and 14% on at least 3 tests. However, cognition did not significantly differ between patients who had chemotherapy and those who did not. A time by group interaction effect was found on the composite cognition score using multi-level modelling suggesting a greater improvement in cognition in the surgery only group over time (p < 0.05). Conclusions: CRC patients display cognitive impairment 10 months after surgery. Chemotherapy did not worsen cognitive impairment but did appear to slow cognitive recovery relative to those undergoing surgery only. The findings demonstrate a clear need for supportive cognitive interventions for all CRC patients following treatment.

Original language	English
Pages (from-to)	1057-1066
Number of pages	10
Journal	Psycho-Oncology
Volume	32
Issue number	7
DOIs	https://doi.org/10.1002/pon.6147
Publication status	Published - Jul 2023

Keywords

cancer
chemotherapy
cognition
colorectal
impairment
oncology
surgery

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1002/pon.6147

Cite this

@article{bd12307ba8ab4751bae4e9091013d77d,

title = "The impact of chemotherapy on cognitive performance post-surgery in patients with colorectal cancer: A prospective cohort study",

abstract = "Objectives: Subjective reports of cognitive impairment following chemotherapy are frequent in cancer patients. Objective cognitive impairment has been observed in cancer patients regardless of treatment regimen suggesting the relationship between cognitive impairment and chemotherapy is not clear cut. Little research has explored the effects of chemotherapy on cognition following surgery in colorectal cancer (CRC). The present study explored the effects of chemotherapy on cognitive performance in a sample of CRC patients. Methods: 136 participants were recruited into a prospective cohort study: 78 CRC patients undergoing surgery and adjuvant chemotherapy, 58 CRC patients undergoing surgery only. A battery of neuropsychological tests was administered to participants 4 weeks post-surgery (T1), 12 weeks after first chemotherapy (T2) and 3 months after last chemotherapy (T3) or equivalent time-points. Results: Using the criterion of scoring at least two standard-deviations below the group norm on at least one neuropsychological test, 45%–55% of all CRC patients showed cognitive deficits 10 months after surgery (T3) and 14% on at least 3 tests. However, cognition did not significantly differ between patients who had chemotherapy and those who did not. A time by group interaction effect was found on the composite cognition score using multi-level modelling suggesting a greater improvement in cognition in the surgery only group over time (p < 0.05). Conclusions: CRC patients display cognitive impairment 10 months after surgery. Chemotherapy did not worsen cognitive impairment but did appear to slow cognitive recovery relative to those undergoing surgery only. The findings demonstrate a clear need for supportive cognitive interventions for all CRC patients following treatment.",

keywords = "cancer, chemotherapy, cognition, colorectal, impairment, oncology, surgery",

author = "Dwek, {Marie Rose} and Newman, {Stanton P.} and Stefano Brini and Pru Holder and Michael Machesney and David Propper and Rixon, {Lorna R.} and Hirani, {Shashivadan P.} and Hurt, {Catherine S.}",

note = "Publisher Copyright: {\textcopyright} 2023 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.",

year = "2023",

month = jul,

doi = "10.1002/pon.6147",

language = "English",

volume = "32",

pages = "1057--1066",

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publisher = "John Wiley and Sons Ltd",

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T1 - The impact of chemotherapy on cognitive performance post-surgery in patients with colorectal cancer

T2 - A prospective cohort study

AU - Dwek, Marie Rose

AU - Newman, Stanton P.

AU - Brini, Stefano

AU - Holder, Pru

AU - Machesney, Michael

AU - Propper, David

AU - Rixon, Lorna R.

AU - Hirani, Shashivadan P.

AU - Hurt, Catherine S.

PY - 2023/7

Y1 - 2023/7

N2 - Objectives: Subjective reports of cognitive impairment following chemotherapy are frequent in cancer patients. Objective cognitive impairment has been observed in cancer patients regardless of treatment regimen suggesting the relationship between cognitive impairment and chemotherapy is not clear cut. Little research has explored the effects of chemotherapy on cognition following surgery in colorectal cancer (CRC). The present study explored the effects of chemotherapy on cognitive performance in a sample of CRC patients. Methods: 136 participants were recruited into a prospective cohort study: 78 CRC patients undergoing surgery and adjuvant chemotherapy, 58 CRC patients undergoing surgery only. A battery of neuropsychological tests was administered to participants 4 weeks post-surgery (T1), 12 weeks after first chemotherapy (T2) and 3 months after last chemotherapy (T3) or equivalent time-points. Results: Using the criterion of scoring at least two standard-deviations below the group norm on at least one neuropsychological test, 45%–55% of all CRC patients showed cognitive deficits 10 months after surgery (T3) and 14% on at least 3 tests. However, cognition did not significantly differ between patients who had chemotherapy and those who did not. A time by group interaction effect was found on the composite cognition score using multi-level modelling suggesting a greater improvement in cognition in the surgery only group over time (p < 0.05). Conclusions: CRC patients display cognitive impairment 10 months after surgery. Chemotherapy did not worsen cognitive impairment but did appear to slow cognitive recovery relative to those undergoing surgery only. The findings demonstrate a clear need for supportive cognitive interventions for all CRC patients following treatment.

AB - Objectives: Subjective reports of cognitive impairment following chemotherapy are frequent in cancer patients. Objective cognitive impairment has been observed in cancer patients regardless of treatment regimen suggesting the relationship between cognitive impairment and chemotherapy is not clear cut. Little research has explored the effects of chemotherapy on cognition following surgery in colorectal cancer (CRC). The present study explored the effects of chemotherapy on cognitive performance in a sample of CRC patients. Methods: 136 participants were recruited into a prospective cohort study: 78 CRC patients undergoing surgery and adjuvant chemotherapy, 58 CRC patients undergoing surgery only. A battery of neuropsychological tests was administered to participants 4 weeks post-surgery (T1), 12 weeks after first chemotherapy (T2) and 3 months after last chemotherapy (T3) or equivalent time-points. Results: Using the criterion of scoring at least two standard-deviations below the group norm on at least one neuropsychological test, 45%–55% of all CRC patients showed cognitive deficits 10 months after surgery (T3) and 14% on at least 3 tests. However, cognition did not significantly differ between patients who had chemotherapy and those who did not. A time by group interaction effect was found on the composite cognition score using multi-level modelling suggesting a greater improvement in cognition in the surgery only group over time (p < 0.05). Conclusions: CRC patients display cognitive impairment 10 months after surgery. Chemotherapy did not worsen cognitive impairment but did appear to slow cognitive recovery relative to those undergoing surgery only. The findings demonstrate a clear need for supportive cognitive interventions for all CRC patients following treatment.

KW - cancer

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