Yassine Eid1, Véronique Bouvier2, Benjamin Menahem3, Alexandre Thobie3, Nathan Dolet4, Morgane Finochi5, Marine Renier6, Joséphine Gardy2, Guy Launoy7, Olivier Dejardin4, Rémy Morello8, Arnaud Alves3. 1. Department of Digestive Surgery, University Hospital of Caen, Avenue de la Côte de Nacre, Caen Cedex, France; "ANTICIPE" U1086 INSERM-University of Caen Normandy, Team Ligue contre le Cancer, Centre François Baclesse, Caen, France; Department of research, University Hospital of Caen, Normandy, France. Electronic address: eidyassine@hotmail.fr. 2. "ANTICIPE" U1086 INSERM-University of Caen Normandy, Team Ligue contre le Cancer, Centre François Baclesse, Caen, France; University Hospital of Caen, Caen cedex, France; Digestive Cancer Registry of Calvados. 3. Department of Digestive Surgery, University Hospital of Caen, Avenue de la Côte de Nacre, Caen Cedex, France; "ANTICIPE" U1086 INSERM-University of Caen Normandy, Team Ligue contre le Cancer, Centre François Baclesse, Caen, France; Department of research, University Hospital of Caen, Normandy, France. 4. "ANTICIPE" U1086 INSERM-University of Caen Normandy, Team Ligue contre le Cancer, Centre François Baclesse, Caen, France; Department of research, University Hospital of Caen, Normandy, France. 5. Department of Digestive Surgery, University Hospital of Caen, Avenue de la Côte de Nacre, Caen Cedex, France; Department of research, University Hospital of Caen, Normandy, France. 6. "ANTICIPE" U1086 INSERM-University of Caen Normandy, Team Ligue contre le Cancer, Centre François Baclesse, Caen, France. 7. "ANTICIPE" U1086 INSERM-University of Caen Normandy, Team Ligue contre le Cancer, Centre François Baclesse, Caen, France; Department of research, University Hospital of Caen, Normandy, France; University Hospital of Caen, Caen cedex, France; Digestive Cancer Registry of Calvados. 8. Department of research, University Hospital of Caen, Normandy, France; Department of Biostatistics and Clinical Research, University Hospital of Caen, Caen Cedex, France.
Abstract
BACKGROUND: With the rising number of rectal cancer survivors, more patients with sphincter-preserving surgery are having to live with a potentially impaired quality of life. The survey aimed to assess bowel and genitourinary sequelae and their impact on quality of life in an unselected registry-based population of rectal cancer survivors. METHODS: This cross-sectional cohort survey (registered at ClinicalTrials.gov; ID: NCT03459235) included patients with rectal cancer who underwent curative surgery with sphincter-preserving surgery from January 1, 2007 to January 31, 2015. Patients with recurrent disease, intestinal stoma, or cognitive disorders were excluded. Validated scoring system included the Urinary Symptom Profile in women and the International Prostate Symptom Score in men for urinary function, International Index for Erectile Function 5 in men and Female Sexual Function Index in women for sexual function, and Core 30/ Colo Rectal 29 questionnaires for quality of life and Low Anterior Resection Syndrome score for bowel function. The impact of functional sequelae on global quality of life was evaluated by multiple linear regression. RESULTS: Responders (45.3%, 92/203 patients) and nonresponders were comparable according to sex, age, tumor stage, and neoadjuvant chemoradiation. With a mean follow-up of 6.5 years, 65.2% of the rectal cancer survivors had bowel dysfunction, of whom 41.3% experienced major Low Anterior Resection Syndrome and 80% of rectal cancer survivors experienced genitourinary dysfunction. In multiple linear regression, poor bowel function was a significant predictor of global quality of life in men (P = .04) and women (P = .0003). CONCLUSION: This survey highlights the importance of sexual and bowel dysfunction in rectal cancer survivors and the strong correlation between high Low Anterior Resection Syndrome score and inferior quality of life. Further studies are needed to improve knowledge on how to predict bowel dysfunction and how to best support patients with bowel dysfunction.
BACKGROUND: With the rising number of rectal cancer survivors, more patients with sphincter-preserving surgery are having to live with a potentially impaired quality of life. The survey aimed to assess bowel and genitourinary sequelae and their impact on quality of life in an unselected registry-based population of rectal cancer survivors. METHODS: This cross-sectional cohort survey (registered at ClinicalTrials.gov; ID: NCT03459235) included patients with rectal cancer who underwent curative surgery with sphincter-preserving surgery from January 1, 2007 to January 31, 2015. Patients with recurrent disease, intestinal stoma, or cognitive disorders were excluded. Validated scoring system included the Urinary Symptom Profile in women and the International Prostate Symptom Score in men for urinary function, International Index for Erectile Function 5 in men and Female Sexual Function Index in women for sexual function, and Core 30/ Colo Rectal 29 questionnaires for quality of life and Low Anterior Resection Syndrome score for bowel function. The impact of functional sequelae on global quality of life was evaluated by multiple linear regression. RESULTS: Responders (45.3%, 92/203 patients) and nonresponders were comparable according to sex, age, tumor stage, and neoadjuvant chemoradiation. With a mean follow-up of 6.5 years, 65.2% of the rectal cancer survivors had bowel dysfunction, of whom 41.3% experienced major Low Anterior Resection Syndrome and 80% of rectal cancer survivors experienced genitourinary dysfunction. In multiple linear regression, poor bowel function was a significant predictor of global quality of life in men (P = .04) and women (P = .0003). CONCLUSION: This survey highlights the importance of sexual and bowel dysfunction in rectal cancer survivors and the strong correlation between high Low Anterior Resection Syndrome score and inferior quality of life. Further studies are needed to improve knowledge on how to predict bowel dysfunction and how to best support patients with bowel dysfunction.
Authors: F Al Rashid; A S Liberman; P Charlebois; B Stein; L S Feldman; J F Fiore; L Lee Journal: Tech Coloproctol Date: 2022-03-03 Impact factor: 3.699