S Pucciarelli1, F Giandomenico1, A De Paoli2, T Gavaruzzi3, L Lotto3,4, G Mantello5, C Barba6, P Zotti7, S Flora2,7, P Del Bianco8. 1. Departments of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy. 2. Department of Radiation Oncology, National Cancer Institute, Aviano, Italy. 3. Developmental Psychology and Socialization, University of Padua, Padua, Italy. 4. Centre for Cognitive Neuroscience, University of Padua, Padua, Italy. 5. Department of Radiotherapy, Ospedali Riuniti, Ancona, Italy. 6. Department of Radiotherapy, Catholic University of Rome, Rome, Italy. 7. Psycho-Oncology Unit, National Cancer Institute, Aviano, Italy. 8. Istituto Oncologico Veneto (IOV-IRCCS), Padua, Italy.
Abstract
BACKGROUND: Local excision for rectal cancer is expected to offer a better functional outcome than conventional surgery. The aim of the present study was to compare quality of life and bowel function in patients with rectal cancer who underwent either local excision or conventional surgery after chemoradiotherapy. METHODS: This was a retrospective multicentre study. Patients who underwent local excision were compared with those who had mesorectal excision. Quality of life and bowel function were investigated using validated questionnaires (European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, EORTC QLQ-CR29 and Memorial Sloan-Kettering Cancer Center Bowel Function Instrument) at a median follow-up of 49 (range 13-95) months. Further analysis was undertaken of data from patients who underwent local excision alone compared with those requiring subsequent radical surgery. Statistical significance was set at P < 0·010. RESULTS: The mean constipation score was significantly better in the local excision group than in the mesorectal excision group (3·8 (95 per cent c.i. 0·3 to 7·2) versus 19·8 (12·1 to 27·4); P < 0·001). Compared with patients who underwent mesorectal excision, those who had local excision had less sensation of incomplete emptying (mean score 3·7 (3·4 to 4·0) versus 2·8 (2·5 to 3·1); P < 0·001) and second bowel movements within 15 min (mean score 3·6 (3·3 to 3·9) versus 3·0 (2·7 to 3·3); P = 0·006). Patients who underwent local excision alone scored better than those who had mesorectal excision, particularly for bowel function, who, in turn, scored better than patients requiring subsequent radical surgery following local excision. CONCLUSION: Patients who underwent local excision had a better quality of life and bowel function than those who underwent mesorectal excision.
BACKGROUND: Local excision for rectal cancer is expected to offer a better functional outcome than conventional surgery. The aim of the present study was to compare quality of life and bowel function in patients with rectal cancer who underwent either local excision or conventional surgery after chemoradiotherapy. METHODS: This was a retrospective multicentre study. Patients who underwent local excision were compared with those who had mesorectal excision. Quality of life and bowel function were investigated using validated questionnaires (European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, EORTC QLQ-CR29 and Memorial Sloan-Kettering Cancer Center Bowel Function Instrument) at a median follow-up of 49 (range 13-95) months. Further analysis was undertaken of data from patients who underwent local excision alone compared with those requiring subsequent radical surgery. Statistical significance was set at P < 0·010. RESULTS: The mean constipation score was significantly better in the local excision group than in the mesorectal excision group (3·8 (95 per cent c.i. 0·3 to 7·2) versus 19·8 (12·1 to 27·4); P < 0·001). Compared with patients who underwent mesorectal excision, those who had local excision had less sensation of incomplete emptying (mean score 3·7 (3·4 to 4·0) versus 2·8 (2·5 to 3·1); P < 0·001) and second bowel movements within 15 min (mean score 3·6 (3·3 to 3·9) versus 3·0 (2·7 to 3·3); P = 0·006). Patients who underwent local excision alone scored better than those who had mesorectal excision, particularly for bowel function, who, in turn, scored better than patients requiring subsequent radical surgery following local excision. CONCLUSION:Patients who underwent local excision had a better quality of life and bowel function than those who underwent mesorectal excision.
Authors: A Barina; A De Paoli; P Delrio; M Guerrieri; A Muratore; F Bianco; D Vespa; C Asteria; E Morpurgo; A Restivo; C Coco; U Pace; C Belluco; C Aschele; S Lonardi; V Valentini; G Mantello; I Maretto; P Del Bianco; A Perin; S Pucciarelli Journal: Tech Coloproctol Date: 2017-07-28 Impact factor: 3.781
Authors: Lawrence Lee; Justin Kelly; George J Nassif; Sam B Atallah; Matthew R Albert; Ravi Shridhar; John R T Monson Journal: J Gastrointest Surg Date: 2017-08-17 Impact factor: 3.452
Authors: Mauro Podda; Patricia Sylla; Gianluca Baiocchi; Michel Adamina; Vanni Agnoletti; Ferdinando Agresta; Luca Ansaloni; Alberto Arezzo; Nicola Avenia; Walter Biffl; Antonio Biondi; Simona Bui; Fabio C Campanile; Paolo Carcoforo; Claudia Commisso; Antonio Crucitti; Nicola De'Angelis; Gian Luigi De'Angelis; Massimo De Filippo; Belinda De Simone; Salomone Di Saverio; Giorgio Ercolani; Gustavo P Fraga; Francesco Gabrielli; Federica Gaiani; Mario Guerrieri; Angelo Guttadauro; Yoram Kluger; Ari K Leppaniemi; Andrea Loffredo; Tiziana Meschi; Ernest E Moore; Monica Ortenzi; Francesco Pata; Dario Parini; Adolfo Pisanu; Gilberto Poggioli; Andrea Polistena; Alessandro Puzziello; Fabio Rondelli; Massimo Sartelli; Neil Smart; Michael E Sugrue; Patricia Tejedor; Marco Vacante; Federico Coccolini; Justin Davies; Fausto Catena Journal: World J Emerg Surg Date: 2021-07-02 Impact factor: 5.469
Authors: Rutger C H Stijns; Eelco J R de Graaf; Cornelis J A Punt; Iris D Nagtegaal; Joost J M E Nuyttens; Esther van Meerten; Pieter J Tanis; Ignace H J T de Hingh; George P van der Schelling; Yair Acherman; Jeroen W A Leijtens; Andreas J A Bremers; Geerard L Beets; Christiaan Hoff; Cornelis Verhoef; Corrie A M Marijnen; Johannes H W de Wilt Journal: JAMA Surg Date: 2019-01-01 Impact factor: 14.766