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Objectives To examine (1) measurement invariance of quality of life (QoL) domains over time for patients with colorectal cancer and partners (i.e., response shift—recalibration, reprioritization, and reconceptualization), (2) between dyad-member measurement invariance and (3) QoL trajectories. Methods Participants completed the WHOQOL-Bref preoperative (Time-0) and 3 (Time-1) and 6 months (Time-2) postoperative. A stepwise procedure, using nested factor models, examined the viability of restricting specific model parameters to be equal across measurements and between dyad members. Findings No reconceptualization and reprioritization was detected, but indications for recalibration were present. Therefore, comparisons were restricted to group-level statistics at factor level. For patients, a decrease in the Physical Health domain occurred at Time-1 (p < 0.001), with partial recovery to baseline at Time-2 (p = 0.055). For partners, factor means in this domain remained constant (p's > 0.05) and were at each time point higher than patients' factor means (p's < 0.05). Patients' and partners' Psychological Health decreased at Time-1 (p's < 0.05), with stabilization at Time-2 (p's > 0.05). Patients and partners' factor means were comparable (p's > 0.05). Patients and partners' Social Relationship factor means decreased at Time-1 (p's < 0.05), which decreased further for patients (p = 0.011) but stabilized for partners (p = 0.214). Partners' factor means were only lower than patients' factor means at Time-1. A similar decrease in the Environmental domain factor means occurred for both patients and partners at Time-l (p's < 0.05), with stabilization at Time-2 (p's > 0.05). Conclusion Since both patients and partners are affected by the patients' disease and treatment, we recommend that attention is paid to the couple instead of solely the patient.

The management of rectal cancer has improved considerably in recent decades. Surgery remains the cornerstone of the treatment. However, the role of preoperative imaging has made it possible to optimize the treatment plan in rectal patients. Neoadjuvant treatment may be indicated in efforts to sterilize possible tumor deposits outside the surgical field, or may be used to downsize and downstage the tumor itself. The optimal sequence of treatment modalities can be determined by a multidisciplinary team, who not only use pretreatment imaging, but also review pathologic results after surgery. The pathologist plays a pivotal role in providing feedback about the success of surgery, i.e., the distance between the tumor and the circumferential resection margin, the quality of surgery, and the effect of neoadjuvant treatment. Registry and auditing of all treatment variables can further improve outcomes. In this century, rectal cancer treatment has become a team effort.