Postoperative Assessment of the Quality of Life in Patients with Colorectal Endometriosis

Mehedințu, Claudia; Frîncu, Francesca; Brînduşe, Lăcrămioara Aurelia; Carp-Velişcu, Andreea; Brătilă, Elvira; Hennetier, Clotilde; Roman, Horace

doi:10.3390/jcm10215211

Cited by 10 publications

(5 citation statements)

References 34 publications

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“…In the pelvis, endometriosis can lead to deeper lesions affecting the bladder, rectum, sigmoid tract, rectovaginal septum, parametrium and/or uterosacral ligaments [5]. These lesions are commonly aggregated under deep infiltrating endometriosis (DIE) [5,6], which often requires extensive surgery leading to severe morbidity [7]. Several studies have now shown that transvaginal sonography (TVS) performed by an expert sonographer can be regarded as being an accurate method in defining DIE nodules and their extension, as magnetic resonance imaging (MRI) [5,8,9]; although, accurate diagnosis of nodules of the uterosacral ligaments and parametrium remains problematic [5].…”

Section: Introductionmentioning

confidence: 99%

The Benefit of Transvaginal Elastography in Detecting Deep Endometriosis: A Feasibility Study

Xholli

Londero²,

Cavalli

et al. 2023

Ultraschall Med

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Objectives: This study aimed to evaluate elastography features of deep infiltrating endometriosis (DIE), and to define whether this technique may discriminate lesions from surrounding non-endometriotic tissue. Methods: This was an exploratory observational study on women affected by DIE treated in a third-level academic hospital gynaecology outpatient facility between 2020 and 2021. Strain elastography (SE) was conducted via transvaginal probe. Tissue deformation of DIE and surrounding tissue was expressed as percentage tissue deformation or as subjective colour score (CS; from blue=stiff to red=soft, assigned numerical values from 0 to 3). Ratios of normal tissue/DIE were compared to ratio of normal tissue/stiffer normal tissue area. Results: Evaluations were performed on 46 DIE nodules and surrounding tissue of the uterosacral ligaments (n=21), parametrium (n=7), rectum (n=14), and recto-vaginal septum (n =4). Irrespective of location, DIE strain ratio (3.09, IQR 2.38–4.14 vs. 1.25, IQR 1.11–1.48; p<0.001) and CS ratio (4.62, IQR 3.83–6.94 vs. 1.13, IQR 1.06–1.29; p<0.001) was significantly higher than that of normal tissue. ROC AUC of CS ratio was higher than ROC AUC of strain ratio (99.76%, CI.95 99.26–100% vs. 91.35%, CI.95 85.23–97.47%; p=0.007), and best ROC threshold for CS ratio was 1.82, with a sensitivity of 97.83% (CI.95 93.48–100%) and a specificity of 100% (CI.95 100-100%). Conclusions: Both strain and CS ratios accurately distinguish DIE nodules at various locations. Applications of elastography in improving the diagnosis DIE, in distinguishing different DIE lesions and in monitoring DIE evolution can be envisioned and are worthy of further evaluation.

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Section: Introductionmentioning

confidence: 99%

The Benefit of Transvaginal Elastography in Detecting Deep Endometriosis: A Feasibility Study

Xholli

Londero²,

Cavalli

et al. 2023

Ultraschall Med

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“…The lowest level of GIQLI points were reported from several disease entities such as 71.3 (49.5% of the maximum) in a cohort of fecal incontinence, 76.6 (53.2% of the maximum) in a cohort of patients with endometriosis, 56.2 (39% of the maximum) in a cohort of patients with irritable bowel syndrome (IBS), and 63 (43.8% of the maximum) in a cohort of patients with constipation [ 33 , 45 , 47 ]. It can be stated as a summary of these results that patients with benign colorectal diseases may suffer from a major reduction in quality of life during the course of the disease, which requires optimal care to improve their situation.…”

Section: Resultsmentioning

confidence: 99%

Quality of life in benign colorectal disease—a review of the assessment with the Gastrointestinal Quality of Life Index (GIQLI)

Fuchs,

Musial,

Retzbach

et al. 2023

Int J Colorectal Dis

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Background and purpose The Gastrointestinal Quality of Life Index (GIQLI) is an instrument for the assessment of quality of life (QOL) in diseases of the upper and lower GI tract, which is validated in several languages around the world. The purpose of this literature review is the assessment of the GIQLI in patients with benign colorectal diseases. Reports on GIQLI data are collected from several institutions, countries, and different cultures which allows for comparisons, which are lacking in literature. Methods The GIQL Index uses 36 items around 5 dimensions (gastrointestinal symptoms (19 items), emotional dimension (5 items), physical dimension (7 items), social dimension (4 items), and therapeutic influences (1 item). The literature search was performed on the GIQLI and colorectal disease, using reports in PubMed. Data are presented descriptively as GIQL Index points as well as a reduction from 100% maximum possible index points (max 144 index points = highest quality of life). Results The GIQLI was found in 122 reports concerning benign colorectal diseases, of which 27 were finally selected for detailed analysis. From these 27 studies, information on 5664 patients (4046 female versus 1178 male) was recorded and summarized. The median age was 52 years (range 29–74.7). The median GIQLI of all studies concerning benign colorectal disease was 88 index points (range 56.2–113). Benign colorectal disease causes a severe reduction in QOL for patients down to 61% of the maximum. Conclusions Benign colorectal diseases cause substantial reductions in the patient’s QOL, well documented by GIQLI, which allows a comparison QOL with other published cohorts.

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“…Thus, decreased scores reported on the subscales “role functioning”, “physical functioning”, and “fatigue symptom”, assessed by the EORTC-C30 questionnaire were key elements that caused the patient to discontinue cancer treatment. In addition, low social support was associated with a 2-fold increased risk for treatment discontinuation [ 71 , 72 ]. Furthermore, Stalmeier et al expose that in clinical practice, the treating physician tends to take ownership of therapeutic decisions, so that the patient does not question the physician about oncological decisions.…”

Section: Discussionmentioning

confidence: 99%

The Impact on Survival of Neoadjuvant Treatment Interruptions in Locally Advanced Rectal Cancer Patients

Lișcu,

Antone-Iordache,

Atasiei

et al. 2024

JPM

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The standard oncologic treatment of locally advanced rectal cancer is long-course radio-chemotherapy followed by surgery and adjuvant chemotherapy. This can result in a lengthy total treatment duration, sometimes up to one year from the diagnosis. Interruptions to neoadjuvant treatment can occur for a variety of reasons, forced or unforced. The main purpose of this study is to analyze the survival data of locally advanced rectal cancer patients who received neoadjuvant treatment and to find a cut-off point showing exactly how many days of interruption of neoadjuvant treatment the risk of death or disease relapse increases. We conducted a retrospective study on 299 patients with locally advanced rectal cancer using survival analysis (Kaplan–Meier curve and Cox regression) to determine survival probabilities for overall survival, local control, and disease-free survival. Patients with 0 to 3 days of neoadjuvant therapy interruption had a higher overall survival probability compared to patients with 4 or more days (90.2% compared to 57.9%, p-value < 0.001), hazard ratio 5.89 (p < 0.001). Local control and disease-free survival had a higher probability in patients with 0–2 days of interruption compared to people with 3 or more days (94% vs. 75.4%, and 82.2% vs. 50.5%, respectively, both p-values < 0.001). Patients with tumoral or nodal downstaging experienced fewer days of interruption than patients with no downstage. These findings reinforce the need for radiation oncologists to be well-organized when starting neoadjuvant treatment for rectal cancer, in order to anticipate and prevent potential treatment interruptions and achieve the best therapeutic results.

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Postoperative Assessment of the Quality of Life in Patients with Colorectal Endometriosis

Cited by 10 publications

References 34 publications

The Benefit of Transvaginal Elastography in Detecting Deep Endometriosis: A Feasibility Study

The Benefit of Transvaginal Elastography in Detecting Deep Endometriosis: A Feasibility Study

Quality of life in benign colorectal disease—a review of the assessment with the Gastrointestinal Quality of Life Index (GIQLI)

The Impact on Survival of Neoadjuvant Treatment Interruptions in Locally Advanced Rectal Cancer Patients

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