Background Living with a stoma is known to impact quality-of-life (QOL) in colorectal cancer (CRC) patients. However, few studies have (1) examined how QOL for stoma patients changes over time and (2) longitudinally compared QOL in CRC patients with and without stoma.

Methods 233 CRC patients were followed up from diagnosis to 12 months post-surgery. Patients were administered the EORTC Core Quality of Life Questionnaire (EORTC QLQ-C30) at baseline, 1-month, 3-month, 6-month, and 12-month. Demographic and clinical data were extracted from electronic medical records.

Results 91 (39.1%) patients required stoma. Both groups were similar at baseline except for tumor site (N=54; 71.1% of rectal patients required stoma) and radiotherapy (N=32; 80.0% requiring radiotherapy also required stoma). QOL in stoma patients was consistently lower than non-stoma patients at all timepoints, across all EORTC QLQ-C30 functioning scales except cognitive, with the biggest differences (approximately 20 points) at 1-month post-surgery. Multilevel mixed-effects tobit regression suggested that requiring a stoma was significantly associated with poorer physical, role, and emotional functioning longitudinally (p<0.05).

Conclusions Most CRC patients suffer impacts to QOL but recover to pre-surgery levels by 12-month. However, stoma patients consistently do worse, and these differences are magnified early in the treatment journey (within first 3 months). Special attention should also be given to post-surgery characteristics suggesting clinical complexity in these patients, such as longer length-of-stay and 30-day readmission.