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Quality of Life after Rectal Cancer Resection Comparing Anterior Resection, Abdominoperineal Resection, and Complicated Cases

Authors :
Jan, Scheele
Johannes, Lemke
Mathias, Wittau
Silvia, Sander
Doris, Henne-Bruns
Marko, Kornmann
Source :
Visc Med
Publication Year :
2022
Publisher :
S. Karger AG, 2022.

Abstract

Introduction: Compared to abdominoperineal resection (APR), sphincter preservation using low anterior resection (AR) for rectal cancer (RC) implies the risk of impaired functional outcome and postoperative complications associated with a persistent or additionally required ostomy. The aim of our study was to compare quality of life (QoL) after AR and APR with a special separate analysis of AR patients with a stoma. Methods: QoL of 84 APR, 356 AR, and 29 AR patients with complications and an additional stoma, termed converted therapy (COT) patients, was compared with regard to groups and effect of radiotherapy (RT). All patients received rectal resection between 1998 and 2013, and 47% of the patients had RT. QoL was assessed using extended EORTC QLQ-C30 and -CR38 questionnaires. Results: Questionnaires from 57 APR, 165 AR, and 25 COT patients alive were evaluated after a median time of 4 years after surgery. Global health status was equally high in AR and APR patients (score: 67), whereas COT patients turned out with a significantly lower score of 50 (p = 0.007). Compared to APR and COT, AR patients revealed less symptoms and higher functionality, especially for physical, role, and social functioning (p < 0.001). The reduction of QoL instances was significant in the COT group and in all patients treated by RT. Conclusion: QoL after RC resection may be further improved by avoiding additionally required ostomy after AR but also RT by a better individual selection of qualified patients. Qualification parameters urgently need to be defined by prospective studies.

Details

ISSN :
2297475X and 22974725
Volume :
38
Database :
OpenAIRE
Journal :
Visceral Medicine
Accession number :
edsair.doi.dedup.....7feebc0094290800b08e39c35e048546
Full Text :
https://doi.org/10.1159/000520945