Digestive and genitourinary sequelae in rectal cancer survivors and their impact on health-related quality of life: Outcome of a high-resolution population-based study

Eid, Yassine; Bouvier, Anne–Marie; Menahem, Benjamin; Thobie, Alexandre; Dolet, Nathan; Finochi, M.; Renier, M.; Gardy, Joséphine; Launoy, Guy; Dejardin, Olivier; Morello, Rémy; Alvès, Arnaud; Abdelli, A.; Ahkong, Marie-Vincent; Alkofer, Barbara; Apoil, Bernard; Argouarch, Louis Paul; Armand, Philippe; Arsène, Dominique; Auvray, Sylvain; Barthélémy, Richard; Bazille, Céline; Bignon, Anne; Bonnamy, Cécile; Bouhier-Leporrier, Karine; Borotto, Eric; Brefort, J. L.; Chomontovski, Jaroslaw; Cohen, Daniel L.; Cojocaru, Michel; Collet, Thierry; Congard, Patrick; Corbinais, Stéphane; Couque, Marc; Degoutte, E; Desfachelles, Jean-Pierre; Dupont, B.; Elfadel, Samouh; Galais, Marie-Pierre; Genuist, Frédéric; Girard, Nicolas; Gloro, Romain; Granveau, Antoine; Guilloit, Jean-Marc; Hervé, Sophie; Hessissen, Mehdi; Jacob, Jacques-Henri; Kalinski, Eric; Koutsomanis, Demetrios; Lagriffoul, Laurent; Lartigau, C.; Lechevallier, Laurent; Lebreton, Gil; Lefebvre, Anne-Charlotte; Lefrançois, Denis; Lepoittevin, Claudine; Leporrier, Julien; Roux, Yannick Le; L’Hirondel, André; L'Hirondel, C; Lion, Laurent; Makki, Ammar; Marchand, Patrice; Marion, Yoann; Mauger, D.; Mosquet, L.; Mura, Denis No; Ollivier, J. M.; Parzy, Aurélie; Polycarpe, Emmanuel; Polycarpe, Florence; Reijasse, Didier; Renet, Catherine; Rodriguez, C.L.; Saadi, Lakhdar; Samama, G; Saplacan, Mihaela; Sleman, Farouk; Siriser, Franck; Soufron, J.; Teste, Yves; Tiengou, Laurent-Eric; Toudic, Jean-Pierre

doi:10.1016/j.surg.2019.04.007

Cited by 30 publications

(30 citation statements)

References 46 publications

(68 reference statements)

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“…It is well known that response rates in retrospective studies are generally lower than response rates in prospective studies. Furthermore, participation rates are often low in surveys on urological and sexual function, and our response rate is comparable to rates reported in similar studies on urinary function [4]. The low response rate could be explained by the fact that many patients find the issue personal and embarrassing.…”

Section: Discussionsupporting

confidence: 72%

“…Over the past decades, development of new methods for early diagnosis, advanced surgical techniques and improved oncological treatment have increased survival from CRC. With improved patient survival, functional results such as faecal incontinence and urinary and sexual dysfunction become increasingly important as they are known to influence quality of life (QoL) [2–4].…”

Section: Introductionmentioning

confidence: 99%

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Urinary dysfunction after colorectal cancer treatment and impact on quality of life—a national cross‐sectional study in males

et al. 2021

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Aim Despite advances in the treatment of colorectal cancer, postoperative urogenital dysfunction is still a problem although its exact extent remains unclear. The aim of this study was to identify the prevalence and patterns of urinary dysfunction in men following treatment for colorectal cancer and the impact of urinary dysfunction on quality of life. Method A retrospective national Danish cross‐sectional study was performed in patients treated for colorectal cancer between 2001 and 2014. Patients answered questionnaires on urinary function and quality of life including the International Consultation on Incontinence Modular Questionnaire—Male Lower Urinary Tract Symptoms measuring voiding and incontinence. Results were analysed based on data on demographics and treatment‐related factors obtained from the Danish Colorectal Cancer Group database. Results A total of 5710 patients responded to the questionnaire (response rate 52.8%). In both crude analysis and after adjusting for patient‐related factors (age, time since surgery and American Society of Anesthesiologists score), both voiding (P < 0.0001) and incontinence scores (P < 0.0001) were significantly higher after rectal cancer than after colon cancer. In the rectal cancer group, abdominoperineal excision was found to be a significant risk factor for both voiding (P < 0.0001) and incontinence (P = 0.011), while radiotherapy only impaired continence (P = 0.014). Significant correlations between high voiding and incontinence scores and impaired quality of life were found in both groups. Conclusion We found a high prevalence of urinary dysfunction following treatment for colorectal cancer, especially in the rectal cancer group. Abdominoperineal excision was the most significant risk factor for both voiding and incontinence. Urinary dysfunction significantly impairs patients' quality of life.

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Section: Discussionsupporting

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Urinary dysfunction after colorectal cancer treatment and impact on quality of life—a national cross‐sectional study in males

et al. 2021

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“…Based on validated instruments and recent studies, 40% of RC survivors suffer from major LARS symptoms at long-term follow-up that significantly impairs their QoL. More interestingly, bowel dysfunction was the only predictor of QoL for such patients after adjustment for age and various QoL components (urinary and sexual function) 33…”

Section: Discussionmentioning

confidence: 98%

“…A 2019 survey highlights the notable functional consequences reported by RC survivors after SPS surgery 33. Based on validated instruments and recent studies, 40% of RC survivors suffer from major LARS symptoms at long-term follow-up that significantly impairs their QoL.…”

Section: Discussionmentioning

confidence: 99%

‘French LARS score’: validation of the French version of the low anterior resection syndrome (LARS) score for measuring bowel dysfunction after sphincter-preserving surgery among rectal cancer patients: a study protocol

et al. 2020

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IntroductionMany bowel problems following low anterior resection (LAR) for rectal cancer considerably impair the quality of life (QoL) of patients. The LAR syndrome (LARS) scale is a self-report questionnaire to identify and assess bowel dysfunction after rectal cancer surgery. It has been translated and validated in several languages but not in French (metropolitan French). The primary objective is to adapt the LARS scale to the French language (called French-LARS score) and to assess its psychometric properties. Secondary objectives are to assess both the prevalence and severity of LARS and to measure their impact on QoL.Methods and analysisA French multicentre observational cohort study has been designed. The validation study will include translation of the LARS scale following the current international recommendations, assessment of its reliability, convergent and discriminant validities, sensitivity, internal consistency, internal validity and confirmatory analyses. One thousand patients will be enrolled for the analyses. The questionnaire will be initially administered to the first 100 patients to verify the adequacy and degree of comprehension of the questions. Then reproducibility will be investigated by a test–retest procedure in the following 400 patients.An analysis will be conducted to determine the correlation between the LARS score and the Quality of Life Questionnaire (QLQ; European Organization for Treatment and Research of Cancer’s QLQ-C30, QLQ-CR29). Risk factors linked to QoL deterioration will be identified and their impact will be measured. This study will meet the need for a validated tool to improve patient care and QoL.Ethics and disseminationThe institutional review board of the University Hospital of Caen and the ethics committee (CPP Nord Ouest I, 25 January 2019) approved the study.Trial registration numberNCT03569488.

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“…Defecation disorders impose limits on daily life activities and mental stress. [25,26] It is considered necessary to treat or prevent defectation disorders after rectal cancer surgery. One study reported that sacral nerve stimulation therapy could effectively alleviate defection disorders.…”

Section: Discussionmentioning

confidence: 99%

Development and evaluation of a Japanese prediction model for low anterior resection syndrome after rectal cancer surgery

Paku

Miyoshi

Fujino

et al. 2020

Preprint

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Background: Low anterior resection syndrome (LARS) is the most common complication after rectal cancer resection. We aimed to identify predictive factors for LARS and to construct and evaluate a predictive model for LARS.Methods: This retrospective study included patients with rectal cancer more than one year after laparoscopic or robotic-assisted surgery. A questionnaire was administered to evaluate the degree of LARS. Clinical characteristics were examined with univariate and multivariate logistic regressions to identify predictive factors for major LARS. The obtained data was divided into learning set and validation set. A predictive model for major LARS was constructed using the learning set, and predictive accuracy of the validation set was assessed.Results: We reviewed a total of 160 patients with rectal cancer and divided them into a learning set (n = 115) and a validation set (n = 45). Univariate and multivariate analyses in the learning set showed that male (odds ratio [OR]: 2.88, 95% confidence interval [95%CI]: 1.11-8.09, p = 0.03), age <75 years (OR: 5.87, 95%CI: 1.14-47.25, p = 0.03) and tumors located <8.5 cm from the AV (OR: 7.20, 95%CI: 2.86-19.49, p <0.01) were significantly related to major LARS. A prediction model based on the patients in learning set was well calibrated.Conclusions: We found that sex, age and tumor location were independent predictors of major LARS in Japanese patients that underwent rectal cancer surgery. Our predictive model for major LARS could aid medical staff in educating and treating patients with rectal cancer before and after surgery.

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Digestive and genitourinary sequelae in rectal cancer survivors and their impact on health-related quality of life: Outcome of a high-resolution population-based study

Cited by 30 publications

References 46 publications

Urinary dysfunction after colorectal cancer treatment and impact on quality of life—a national cross‐sectional study in males

Urinary dysfunction after colorectal cancer treatment and impact on quality of life—a national cross‐sectional study in males

‘French LARS score’: validation of the French version of the low anterior resection syndrome (LARS) score for measuring bowel dysfunction after sphincter-preserving surgery among rectal cancer patients: a study protocol

Development and evaluation of a Japanese prediction model for low anterior resection syndrome after rectal cancer surgery

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