Prospective assessment of the quality of life in patients treated surgically for rectal cancer with lower anterior resection and abdominoperineal resection

Monastyrska, Ewelina; Hagner, Wojciech; Jankowski, Michał; Głowacka, Iwona; Zegarska, Barbara; Zegarski, Wojciech

doi:10.1016/j.ejso.2016.07.007

Cited by 22 publications

(38 citation statements)

References 20 publications

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“…These results are consistent with other studies that reported higher scores for emotional and cognitive functions in DC patients and more gastrointestinal problems after LAR [10, 12, 21]. In contrast, Monastyrska et al [23] recorded better emotional and cognitive functional scale scores for SP subjects in a recent series with a follow-up of 6 months after surgery.…”

Section: Discussionsupporting

confidence: 92%

Late assessment of quality of life in patients with rectal carcinoma: comparison between sphincter preservation and definitive colostomy

Silva

Aguiar

Pastore

et al. 2018

Int J Colorectal Dis

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PurposePatients with cancer of the lower and middle rectum who are candidates for curative surgery often have negative opinions on definitive colostomy. The purpose of this study is to compare the quality of life (QoL) of patients who undergo standard treatment for rectal cancer with sphincter preservation or definitive colostomy.MethodsA total of 125 patients with adenocarcinoma of the lower or middle rectum who underwent radical surgery with curative intent with a follow-up ≥ 1 year were recruited: 83 patients (group 1) were subjected to low anterior resection and low colorectal or coloanal anastomosis—thus preserving their sphincter—and 42 (group 2) were treated with abdominoperineal resection, followed by terminal definitive colostomy. QoL was assessed with the EORTC QLQ-C30 and QLQ-CR29 questionnaires.ResultsHealth and global quality of life were similar between groups; however, patients who underwent definitive colostomy had higher scores on the emotional (p value = 0.016) and cognitive function scales (p value = 0.017). Patients with sphincter preservation presented with more symptoms that were related to stool frequency (p value < 0.001), intestinal constipation (p value = 0.005), fecal incontinence (p value = 0.001), buttock pain (p value = 0.023), and nausea and vomiting (p value = 0.036), whereas patients with permanent colostomy had higher scores for dysuria (p value = 0.033).ConclusionAlthough global QoL scores did not differ between groups, patients who underwent definitive colostomy had significantly better functional and symptom scale scores, reflecting greater function with fewer symptoms.Electronic supplementary materialThe online version of this article (10.1007/s00384-018-3044-4) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 92%

Late assessment of quality of life in patients with rectal carcinoma: comparison between sphincter preservation and definitive colostomy

Silva

Aguiar

Pastore

et al. 2018

Int J Colorectal Dis

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“…In fact, in a survey, patients said they were willing to accept higher rates of tumor recurrence and decreased survival to avoid radical surgery 15 . Several studies have indeed shown that there is a decrease in quality of life after surgery for rectal cancer, although this decrease often returns to baseline within 6 months to 2 years after surgery 20,30 …”

Section: Discussionmentioning

confidence: 99%

“…15 Several studies have indeed shown that there is a decrease in quality of life after surgery for rectal cancer, although this decrease often returns to baseline within 6 months to 2 years after surgery. 20,30 Another reason for surgery refusal may be a complete response following neoadjuvant chemoradiation. Up to 40% of patients may show a complete pathologic response following neoadjuvant chemoradiation.…”

Section: Discussionmentioning

confidence: 99%

Treatment of stage I‐III rectal cancer: Who is refusing surgery?

Fields

Yoo

et al. 2020

Journal of Surgical Oncology

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Background and Objectives Surgical resection is a cornerstone in the management of patients with rectal cancer. Patients may refuse surgical treatment for several reasons although the rate of refusal is currently unknown. Methods The National Cancer Database was utilized to identify patients with stage I‐III rectal cancer. Patients who refused surgical resection were compared to patients who underwent curative resection. Results A total of 509 (2.6%) patients with stage I and 2082 (3.5%) patients with stage II/III rectal cancer refused surgery. In multivariable analysis for stage I disease, older age, Black race, and Medicaid/no insurance were independent predictors of surgery refusal. Patients were less likely to refuse surgery if they had a higher income or lived further distances from the treatment facility. In multivariable analysis for stage II/III disease, older age, Black race, insurance other than private, and rural county were independent predictors of surgery refusal. Patients were less likely to refuse surgery if they had higher Charlson comorbidity scores, lived further distances from the treatment facility, or underwent chemoradiation. There was a significant decrease in survival for patients refusing surgery compared to patients undergoing recommended surgery. Conclusions A small proportion of patients refuse surgery for rectal cancer, and this treatment decision significantly affects survival.

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“…Until recently, no large-scale prospective study has compared QOL after APR or SPS for low rectal cancer, although a permanent stoma following rectal cancer excision is believed to have a detrimental effect on QOL [ 10 , 11 ]. A prospective study of 62 patients 1 year after surgical treatment for low rectal cancer showed that QOL was similar after APR and SPS [12] .…”

Section: Introductionmentioning

confidence: 99%

“…A prospective study of 62 patients 1 year after surgical treatment for low rectal cancer showed that QOL was similar after APR and SPS [12] . However, previous studies that compared QOL after these two procedures had limited generalisability, primarily due to a lack of prospective cohort studies, the heterogeneity of tumour locations, the lack of preoperative baseline data, short-term follow-ups, or the failure to consider confounding factors [10] , [11] , [12] , [13] , [14] . A randomised controlled trial comparing the outcomes of APR and SPS should provide strong support for these surgical strategies for low rectal cancer, but such studies are not feasible because most patients prefer SPS to other methods.…”

Section: Introductionmentioning

confidence: 99%

Quality of life after sphincter preservation surgery or abdominoperineal resection for low rectal cancer (ASPIRE): A long-term prospective, multicentre, cohort study

Kang¹,

Cho²,

Jeong

et al. 2021

The Lancet Regional Health - Western Pacific

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Background: The long-term effects of radical resection on quality of life may influence the treatment selection. The objective of this study was to determine whether abdominoperineal resection has a better effect on the quality of life than sphincter preservation surgery at 3 years after surgery Methods: This prospective, cohort study included patients who underwent radical resection for low rectal cancer. The primary outcomes were European Organisation for Research and Treatment of Cancer QLQ-C30 and CR38 quality of life scores 3 years after surgery, which were compared with linear generalised estimating equations, after adjustment for baseline values, a time effect, and an interaction effect between time and treatment. The secondary outcomes included sexual-urinary functions and oncological outcomes. The study was registered with ClinicalTrials.gov (NCT01461525). Findings: Between December 2011 and August 2016, 342 patients were enrolled: 268 (78 • 4%) underwent sphincter preservation surgery and 74 (21 • 6%) underwent abdominoperineal resection. The global quality of life scores did not differ between sphincter preservation surgery and abdominoperineal resection groups (adjusted mean difference, 4 • 2 points on a 100-point scale; 95% confidence interval [CI], −1 • 3 ✩ Registry URL: https://clinicaltrials.gov/ct2/show/NCT01461525?term=abdominoperineal+resection&cond=rectal+cancer&draw=2&rank=3 ✩✩ Study Acronym: ASPIRE, A bdominoperineal resection versus SP hincter preservation surgery I n low RE ctal cancer * Corresponding author.

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Prospective assessment of the quality of life in patients treated surgically for rectal cancer with lower anterior resection and abdominoperineal resection

Cited by 22 publications

References 20 publications

Late assessment of quality of life in patients with rectal carcinoma: comparison between sphincter preservation and definitive colostomy

Late assessment of quality of life in patients with rectal carcinoma: comparison between sphincter preservation and definitive colostomy

Treatment of stage I‐III rectal cancer: Who is refusing surgery?

Quality of life after sphincter preservation surgery or abdominoperineal resection for low rectal cancer (ASPIRE): A long-term prospective, multicentre, cohort study

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