---
title: "Five-year prevalence and predictors of fatigue after rectal cancer treatment (QoLiRECT study)"
id: "pubmed-42755298"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42755298"
content_type: "clinical_feed_article"
specialty: "Oncology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42755298/"
doi: "10.2340/1651-226X.2026.46460"
published_at: "2026-09-18T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Five-year prevalence and predictors of fatigue after rectal cancer treatment (QoLiRECT study)
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42755298
- **Specialty:** [Oncology](https://medichelpline.com/clinical-feed/oncology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42755298/)
- **DOI:** [10.2340/1651-226X.2026.46460](https://doi.org/10.2340%2F1651-226X.2026.46460)
- **Published At:** 2026-09-18T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This multicentre, prospective QoLiRECT study assessed **fatigue** at 5 years after surgery for **rectal cancer** using the **Piper Fatigue Scale (PFS)**. - 1,024 patients who underwent rectal cancer surgery were enrolled; 593 responded to the 5-year follow-up questionnaire. Baseline and 5-year cohorts were reported as comparable. - At 5 years, 52.4% of respondents reported any fatigue; 29.0% had moderate–severe fatigue (PFS ≥ 4). - Higher baseline body mass index (BMI) was associated with moderate–severe fatigue (univariate OR 1.07 per unit BMI, 95% CI 1.02–1.11, p = 0.004), with similar findings in multivariable analysis. - Major low anterior resection syndrome (LARS) and having a permanent stoma were associated with PFS ≥ 4 in univariate analyses (major LARS OR 2.17, 95% CI 1.09–4.34, p = 0.028; permanent stoma OR 1.92, 95% CI 1.06–3.47, p = 0.032). - General pain showed a strong association with moderate–severe fatigue (univariate OR 4.34, 95% CI 2.91–6.49, p < 0.0001; multivariate OR 2.8, 95% CI 1.79–4.58, p < 0.0001). - Higher overall quality of life (QoL) was inversely associated with moderate–severe fatigue in both uni- and multivariable analyses (univariate OR 0.37, 95% CI 0.30–0.46, p < 0.0001; multivariate OR 0.34, 95% CI 0.27–0.4, p < 0.0001). - Data sources included the QoLiRECT prospective study and Swedish and Danish colorectal cancer registries. Logistic regression was used to identify predictors of moderate–severe fatigue. - The authors conclude that **moderate–severe fatigue** is prevalent among rectal cancer survivors at 5 years and that targeted prevention could improve overall **quality of life**. Specific intervention strategies and further methodological details were not reported in the abstract.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliations * 1 Department of Surgery, SSORG - Scandinavian Surgical Outcomes Research Group, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Surgery, Växjö Hospital, Region Kronoberg, Sweden. johan.ekstrand@gu.se. * 2 Department of Surgery, SSORG - Scandinavian Surgical Outcomes Research Group, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. * 3 Department of Surgery, SSORG - Scandinavian Surgical Outcomes Research Group, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. * 4 Department of Surgery, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark. * PMID: **42755298** * DOI: [ 10.2340/1651-226X.2026.46460 ](https://doi.org/10.2340/1651-226x.2026.46460) Item in Clipboard Multicenter Study # Fatigue five years after treatment for rectal cancer - results from the QoLiRECT study Johan Ekstrand et al. Acta Oncol. 2026. Show details Display options Display options Format Abstract PubMed PMID Acta Oncol Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Acta+Oncol%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Acta+Oncol%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42755298/) . 2026 Sep 18:65:758-765. doi: 10.2340/1651-226X.2026.46460. ### Authors [Johan Ekstrand](https://pubmed.ncbi.nlm.nih.gov/?term=Ekstrand+J&cauthor_id=42755298)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42755298/#short-view-affiliation-1 "Department of Surgery, SSORG - Scandinavian Surgical Outcomes Research Group, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Surgery, Växjö Hospital, Region Kronoberg, Sweden. johan.ekstrand@gu.se."), [Rode Grönkvist](https://pubmed.ncbi.nlm.nih.gov/?term=Gr%C3%B6nkvist+R&cauthor_id=42755298)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42755298/#short-view-affiliation-2 "Department of Surgery, SSORG - Scandinavian Surgical Outcomes Research Group, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden."), [Carolina Ehrencrona](https://pubmed.ncbi.nlm.nih.gov/?term=Ehrencrona+C&cauthor_id=42755298)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42755298/#short-view-affiliation-3 "Department of Surgery, SSORG - Scandinavian Surgical Outcomes Research Group, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden."), [Elisabeth Gonzalez](https://pubmed.ncbi.nlm.nih.gov/?term=Gonzalez+E&cauthor_id=42755298)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42755298/#short-view-affiliation-3 "Department of Surgery, SSORG - Scandinavian Surgical Outcomes Research Group, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden."), [Jacob Rosenberg](https://pubmed.ncbi.nlm.nih.gov/?term=Rosenberg+J&cauthor_id=42755298)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42755298/#short-view-affiliation-4 "Department of Surgery, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark."), [Eva Haglind](https://pubmed.ncbi.nlm.nih.gov/?term=Haglind+E&cauthor_id=42755298)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42755298/#short-view-affiliation-3 "Department of Surgery, SSORG - Scandinavian Surgical Outcomes Research Group, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden."), [Eva Angenete](https://pubmed.ncbi.nlm.nih.gov/?term=Angenete+E&cauthor_id=42755298)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42755298/#short-view-affiliation-3 "Department of Surgery, SSORG - Scandinavian Surgical Outcomes Research Group, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.") ### Affiliations * 1 Department of Surgery, SSORG - Scandinavian Surgical Outcomes Research Group, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Surgery, Växjö Hospital, Region Kronoberg, Sweden. johan.ekstrand@gu.se. * 2 Department of Surgery, SSORG - Scandinavian Surgical Outcomes Research Group, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. * 3 Department of Surgery, SSORG - Scandinavian Surgical Outcomes Research Group, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. * 4 Department of Surgery, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark. * PMID: **42755298** * DOI: [ 10.2340/1651-226X.2026.46460 ](https://doi.org/10.2340/1651-226x.2026.46460) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background and purpose:** Fatigue affects colorectal cancer survivors and has a significant impact on overall quality of life (QoL) and possible negative effects on overall survival. The aim of this study was to investigate fatigue prevalence at 5 years after rectal cancer surgery using the Piper Fatigue Scale (PFS). Patient/material and methods: Data was collected from the QoLiRECT study, an international, prospective longitudinal multicentre study of patients with rectal cancer also using data from the Swedish and Danish colorectal cancer registries. Baseline characteristics and treatment-related factors were investigated as potential predictors of moderate-severe fatigue using logistic regression in univariate and multivariate analysis. Patients were included at diagnosis and before treatment and answered questionnaires about bodily functions, symptoms and QoL at baseline and 1, 2 and 5 years after diagnosis. **Results:** The cohort consisted of 1024 patients who underwent surgery for rectal cancer. 593 patients responded to the 5-year follow-up questionnaire. Demographic analysis showed comparable baseline and 5-year cohorts. At 5 years, 52.4% of patients experienced fatigue. Moderate-severe fatigue (PFS≥4) was reported by 172 patients (29.0%). Higher BMI at baseline was associated with PFS≥4 (OR 1.07, 95% CI 1.02-1.11, p=0.004) in the univariate analysis, with similar results in multivariate analysis. Major LARS (OR 2.17, 95% 1.09-4.34, p=0.028) and permanent stoma (OR 1.92, 95% CI 1.06-3.47, p=0.032) was associated with PFS≥4 the univariate analysis. A significant association was found between general pain and moderate-to-severe fatigue. In univariate analysis, the OR was 4.34 (p<0.0001, 95% CI 2.91-6.49), and in multivariate analysis, 2.8 (p<0.0001, 95% CI 1.79-4.58). Higher QoL was negatively correlated to PFS≥4 in both uni- and multivariate analyses (OR 0.37, 95% CI 0.30-0.46, p<0.0001; OR 0.34, 95% CI 0.27-0.4 p<0.0001). **Interpretation:** Moderate-severe fatigue is prevalent in rectal cancer survivors. Targeted prevention of fatigue could improve overall QoL in these patients. 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