Short–term effects of neoadjuvant chemoradiation therapy on anorectal function in rectal cancer patients: a pilot study

Kye, Bong-Hyeon; Kim, Hyungjin; Kim, Jun-Gi; Kim, Sunghwan; Shim, Bong Suk; Lee, Nan-Sook; Cho, Hyeon-Min

doi:10.1186/1748-717x-8-203

Cited by 8 publications

(10 citation statements)

References 19 publications

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“…There are varying reports regarding the changes in manometric parameters between before and after PCRT. In some studies [ 19 , 20 ], SL increased as in the present study. In terms of pressure profiles, there have been contradictory reports [ 3 , 20 - 22 ].…”

Section: Discussionsupporting

confidence: 82%

“…In the present study, a significant decrease in MTV was found subsequent to PCRT. Some studies [ 3 , 19 , 20 ] reported decreases in MTV after PCRT, but the differences were not statistically significant. Although some have also reported a decrease in rectal compliance [ 20 ], the present study did not find such a difference.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies on the influence of PCRT on anorectal function have evaluated long-term functionality after SPS [ 1 , 3 , 12 - 14 , 16 , 17 ]. However, it is not easy to investigate the direct effects of PCRT on anorectal function since deterioration of anorectal function occurs when PCRT is combined with SFS [ 8 , 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

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Peri-treatment change of anorectal function in patients with rectal cancer after preoperative chemoradiotherapy

et al. 2017

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Preoperative chemoradiotherapy (PCRT) is a standard treatment for locally advanced rectal cancer. The influence of PCRT on anorectal function has not been objectively assessed. We evaluated the short-term influence of PCRT on anorectal function in patients with locally advanced rectal cancer using anorectal manometry. We included 310 patients with locally advanced mid and lower rectal cancer who underwent PCRT from 2012 to 2015. We compared anorectal function based on anorectal manometry between before and after PCRT according to tumor location, clinical T (cT) stage, and tumor response after PCRT. Lower rectal cancer was common in the cohort of 310 patients (n = 228, 73.5%). Sphincter length (p = 0.003) and maximal resting pressure (p < 0.001) increased and maximal tolerated volume (p = 0.036) decreased after PCRT regardless of tumor location. Maximal squeezing pressure and rectal compliance slightly decreased, without statistical significance. Changes in manometric parameters after PCRT were not associated with changes of cT stage after PCRT. However, minimal sensory volume (p = 0.042) and maximal tolerated volume (p = 0.025) increased significantly in 143 patients (46.1%) with changes in the distance of the cancer from the anal verge after PCRT. PCRT did not impair the overall short-term anorectal manometric parameters in patients with locally advanced rectal cancer. Further study is required to investigate postoperative anorectal function after sphincter-preserving surgery to evaluate the long-term effects of PCRT on anorectal function.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Peri-treatment change of anorectal function in patients with rectal cancer after preoperative chemoradiotherapy

et al. 2017

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“…In another study considering the short-term preoperative change of anorectal function based on manometric data after nCRT, tumor response of chemoradiation was shown to be significantly associated with sensory threshold for desire to defecate and thus potential benefit of nCRT on defecatory function and local disease control has been suggested, at least in the short-term period after the radiation [ 48 ].…”

Section: Resultsmentioning

confidence: 99%

Long-term effects of neoadjuvant chemoradiotherapy followed by sphincter-preserving resection on anal sphincter function in relation to quality of life among locally advanced rectal cancer patients: a cross-sectional analysis

et al. 2015

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BackgroundThere is growing recognition for the consequences of rectal cancer treatment to maintain an adequate functional sphincter in the long-term rather than preserving the anal sphincter itself. This study aims to evaluate long-term effects of neoadjuvant chemoradiotherapy (nCRT) followed by sphincter-preserving resection on anal sphincter function in relation to quality of life (QoL) among locally advanced rectal cancer patients.MethodsTwenty-nine patients treated with nCRT followed by low anterior resection surgery were included in this study. Data on patient demographics, tumor location and symptoms of urgency and fecal soiling were recorded and evaluated with respect to Wexner Fecal Incontinence Scoring Scale, European Organization for Research and Cancer (EORTC) cancer-specific (EORTC QLQ-C30) and colorectal cancer-specific (EORTC QLQ-CR38) questionnaires and anorectal manometrical findings. Correlation of manometrical findings with Wexner Scale, EORTC QLQ-CR38 scores and EORTC QLQ-C30 scores was also evaluated.ResultsMedian follow-up was 45.6 months (ranged 7.5–98 months. Higher scores for incontinence for gas (p = 0.001), liquid (p = 0.048) and solid (p = 0.019) stool, need to wear pad (p = 0.001) and alteration in life style (p = 0.004) in Wexner scale, while lower scores for future perspective (p = 0.010) and higher scores for defecation problems (p = 0.001) in EORTC QLQ-CR38 were noted in patients with than without urgency. Manometrical findings of resting pressure (mmHg) was positively correlated with body image (r = 0.435, p = 0.030) and sexual functioning (r = 0.479, p = 0.011) items of functional scale, while rectal sensory threshold (RST) volume (mL) was positively correlated with defecation problems (r = 0.424, p = 0.031) items of symptom scale in EORTC QLQ-CR38 and negatively correlated with social function domain (r = −0.479, p = 0.024) in EORTC QLQ-C30. RST volume was also positively correlated with Wexner scores including incontinence for liquid stool (r = 0.459, p = 0.024), need to wear pad (r = 0.466, p = 0.022) and alteration in lifestyle (r = 0.425, p = 0.038).ConclusionThe high risk of developing functional anal impairment as well as the systematic registration of not only oncological but also functional and QoL related outcomes seem important in rectal cancer patients in the long-term disease follow-up.

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“…Therefore, a novel objective method combined with the traditional questionnaire survey should be optimally applied to evaluate the change in anorectal function following rectal surgery. Anorectal manometry has been found to be an effective and objective test for evaluating postoperative anorectal function (15,16). We previously performed anorectal manometry combined with a questionnaire survey to evaluate the anorectal function of Chinese patients following partial intersphincteric resection and transanal endoscopic microsurgery (17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

Anorectal functional outcome following laparoscopic low anterior resection for rectal cancer

Liu

Yan

Shan

et al. 2017

Molecular and Clinical Oncology

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Abstract. Low anterior resection (LAR) with total mesorectal excision has been considered a standard treatment for patients with rectal cancer. However, the functional outcome and life quality of laparoscopic LAR (LLAR) in Chinese patients remain unclear. A cohort of 51 Chinese patients (22 men and 29 women) who had undergone LLAR was included in this study. Anorectal manometry combined with the Wexner scores questionnaire were applied to assess functional outcome preoperatively (1 week) and postoperatively (at 3, 6 and 9 months). The validated Chinese versions of the European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-CR38 questionnaires were also used to assess the patients' quality of life at the indicated time points. The results demonstrated that the manometric parameters exhibited a temporary decrease at 3 months postoperatively, but a gradual increase at 6 and 9 months, while the Wexner scores exhibited an opposite trend. Furthermore, patients with high anastomoses had significantly higher manometric parameters, a lower frequency of incontinence and lower Wexner scores compared with those with low anastomoses at 9 months (all P<0.05). For the entire cohort, quality of life at 3 months postoperatively was worse compared with the preoperative level, but returned to normal by 9 months. Patients with high anastomoses exhibited significantly better role, emotional and social function, had a better body image and sexual function, fewer problems with defecation and lower frequency of diarrhea, as well as fewer chemotherapy-related side effects at 6 months postoperatively when compared with the low anastomosis group (all P<0.05). In conclusion, LLAR is generally acceptable for Chinese patients with rectal cancer, particularly for those with middle or high rectal cancer, in terms of functional outcome and quality of life.

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Short–term effects of neoadjuvant chemoradiation therapy on anorectal function in rectal cancer patients: a pilot study

Cited by 8 publications

References 19 publications

Peri-treatment change of anorectal function in patients with rectal cancer after preoperative chemoradiotherapy

Peri-treatment change of anorectal function in patients with rectal cancer after preoperative chemoradiotherapy

Long-term effects of neoadjuvant chemoradiotherapy followed by sphincter-preserving resection on anal sphincter function in relation to quality of life among locally advanced rectal cancer patients: a cross-sectional analysis

Anorectal functional outcome following laparoscopic low anterior resection for rectal cancer

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