Functional bowel complaints and quality of life after surgery for colon cancer: prevalence and predictive factors

Abstract

Aim Low anterior resection syndrome (LARS) severely affects the quality of life (QoL) of patients after surgery for rectal cancer. There are very few studies that have investigated LARS-like symptoms and their effect on QoL after colon cancer surgery. The aim of this study was to investigate the prevalence of functional abdominal complaints and related QoL after colon cancer surgery compared with patients with similar complaints after rectal cancer surgery.Method All patients who underwent colorectal cancer resections between January 2008 and December 2015, and who were free of colostomy for at least 1 year, were eligible (n = 2136). Bowel function was assessed by the LARS score, QoL by the EORTC QLQ-C30 and QLQ-CR29 questionnaires. QoL was compared between the LARS score categories and tumour height categories.Results A total of 1495 patients (70.0%) were included in the analyses, of whom 1145 had a colonic and 350 a rectal tumour. Symptoms of LARS were observed in 55% after rectal cancer resection compared with 21% after colon cancer resection. Female gender (OR 1.88, CI 1.392-2.528) and a previous diverting stoma (OR 1.84, CI 1.14-2.97) were independently associated with a higher prevalence of LARS after colon cancer surgery. Patients with LARS after colon cancer surgery performed significantly worse in most QoL domains.Conclusion The results of this study highlight the presence of LARS-like symptoms after surgery for colonic cancer. Patients suffering from major LARS-like symptoms after colon resection reported the same debilitating effect on their QoL as patients with major LARS after rectal resection. This should be addressed by colorectal cancer specialists in order to adequately inform patients.Keywords Health-related quality of life, bowel dysfunction, low anterior resection syndrome, colorectal cancer, colonic resection What does this paper add to the literature? Low anterior resection syndrome (LARS) severely affects quality of life (QoL) after rectal cancer surgery. This is the first study to raise awareness of the presence of LARS-like symptoms after surgery for colon cancer, with patients having the same debilitating effect on their QoL as patients with major LARS after rectal resection.

Risk of Pharmacological or Hospital Treatment for Depression in Patients with Colorectal Cancer–Associations with Pre-Cancer Lifestyle, Comorbidity and Clinical Factors

“…3 Comorbidity is classified according to a modified the Charlson Comorbidity Index (CCI), excluding cancer. 4 Based on recommendations from the Danish Health Authorities at time of inclusion. Moderate use, 1-14 drinks per week for women and 1-21 drinks per week for men.…”

“…3 Adjusted for 1 + 2+ stage + cancer type. 4 At time of enrollment in the Diet, Cancer and Health Cohort. 5 Based on recommendations from the Danish Health Authorities at time of enrollment.…”

“…Due to the enhanced screening and prevention efforts and improved treatments in high-income countries, the mortality rates for colorectal cancer (CRC) have decreased [1]. Survivors after colorectal cancer often suffer from late effects from the cancer and its treatments [2,3] that may affect their wellbeing and quality of life [4,5].…”

A challenging journey: The experience of elderly patients and their close family members after major emergency abdominal surgery

“…This affected emotional well‐being for some; impatience and frustration accumulated; and the recovery process seemed like an unequal struggle. Likewise, studies investigating patients recovering from colorectal cancer surgery (10, 51) and patients recovering after critical illness (13, 44) to refer to normal life as it was before illness; however, the postoperative recovery process was slow and not comparable to life before surgery (10, 51). For critically ill patients, full recovery was not always achievable due to cognitive or physical impairment, which was hard to accept (13, 44).…”

Chronic constipation in adults: Contemporary perspectives and clinical challenges. 1: Epidemiology, diagnosis, clinical associations, pathophysiology and investigation

“…These symptoms are collectively referred to as the low anterior resection syndrome (LARS), with 40%–50% of patients having long‐term LARS to an extent that it significantly impairs their quality of life 97,98 . In patients undergoing surgery for colon cancer, a recent study showed that 21% suffered from LARS‐like symptoms post‐operatively 99 ; this is a similar proportion to the number of patients reporting a sense of incomplete rectal emptying after sigmoid colectomy 100 …”