Quality of life after rectal resection for cancer, with or without permanent colostomy.

Pachler, Jørn; Wille‐Jørgensen, Peer

doi:10.1002/14651858.cd004323.pub3

Cited by 102 publications

(28 citation statements)

References 75 publications

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“…There is some evidence that the functional result after AR is acceptable in older patients[15], and chronological age alone should not exclude patients from restorative surgery for rectal cancer. However, available studies comparing quality of life in patients treated for rectal cancer with a permanent stoma (HA) and restorative surgery (AR) do not demonstrate a significant difference between the two alternatives [16,17]. Further prospective studies in this aspect are important, since the short-term and long-term survival did not differ significantly between patients in the AR and HA groups in our audit.…”

Section: Discussionmentioning

confidence: 68%

Rectal cancer treatment and outcome in the elderly: an audit based on the Swedish rectal cancer registry 1995–2004

et al. 2009

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BackgroundLimited information is available regarding the effect of age on choice of surgical and oncological treatment for rectal cancer. The objective of this study was to assess the influence of age on treatment and outcome of rectal cancer.MethodsWe utilized data in the Swedish Rectal Cancer Registry (SRCR) from patients treated for rectal cancer in Sweden in 1995–2004.ResultsA total of 15,104 patients with rectal cancer were identified, 42.4% of whom were 75 years or older. Patients ≥75 years were less likely to have distant metastases than younger patients (14.8% vs. 17.8%, P < 0.001), and underwent abdominal tumor resection less frequently (68.5% vs. 84.4%, P < 0.001). Of 11,725 patients with abdominal tumor resection (anterior resection [AR], abdominoperineal excision [APE], and Hartmann's procedure [HA]), 37.4% were ≥75 years. Curative surgery was registered for 85.0% of patients ≥ 75 years and for 83.9% of patients < 75 years, P = 0.11. Choice of abdominal operation differed significantly between the two age groups for both curative and non-curative surgery, The frequency of APE was similar in both age groups (29.5% vs. 28.6%), but patients ≥75 years were more likely to have HA (16.9% vs. 4.9%) and less likely to have preoperative radiotherapy (34.3vs. 67.2%, P < 0.001). The relative survival rate at five years for all patients treated with curative intent was 73% (70–75%) for patients ≥75 years and 78% (77–79%) for patients < 75 years of age. Local recurrence rate was 9% (8–11%) for older and 8% (7–9%) for younger patients.ConclusionTreatment of rectal cancer is influenced by patient's age. Future studies should include younger and older patients alike to reveal whether or not age-related differences are purposive. Local recurrence following surgery for low tumors and quality of life aspects deserve particular attention.

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Section: Discussionmentioning

confidence: 68%

Rectal cancer treatment and outcome in the elderly: an audit based on the Swedish rectal cancer registry 1995–2004

et al. 2009

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“…A 2005 Cochrane review26 regarding the QOL of rectal cancer patients undergoing LAR and APR evaluated a sample of 1,412 from 25 studies. The authors concluded that the studies reviewed did not confirm any conclusions about the QOL of patients undergoing APR being inferior or superior to that of patients who underwent LAR and opined that better designed studies with larger samples are required.…”

Section: Discussionmentioning

confidence: 99%

Abdominoperineal resection does not decrease quality of life in patients with low rectal cancer

Campos-Lobato

Alves-Ferreira

Lavery

et al. 2011

Clinics

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PURPOSE:Issues related to body image and a permanent stoma after abdominoperineal resection may decrease quality of life in rectal cancer patients. However, specific problems associated with a low anastomosis may similarly affect quality of life for patients undergoing low anterior resection. The aim of this study was to compare quality of life of low rectal cancer patients after undergoing abdominoperineal resection versus low anterior resection.METHODS:Demographics, tumor and treatment characteristics, and prospectively collected preoperative quality-of-life data for patients undergoing low anterior resection or abdominoperineal resection for low rectal cancer between 1995 and 2009 were compared. Quality of life collected at specific time intervals was compared for the two groups, adjusting for age, body mass index, use of chemoradiation, and 30 days postoperative complications. The short-form-36 questionnaire was used to determine quality of life.RESULTS:The query returned 153 patients (abdominoperineal resection = 68, low anterior resection = 85) with a median follow-up of 24 (3-64) mo. The after abdominoperineal resection group had a higher mean age (63 ± 12 vs. 54 ± 12, p < 0.001) and more American Society of Anesthesiologists classification 3/4 patients (65 percent vs. 43 percent, p = 0.03) than low anterior resection. Other demographics, tumor stage, use of chemoradiation, overall postoperative complication rates, and quality-of-life follow-up time were not statistically different in both groups. Patients undergoing abdominoperineal resection had a lower baseline short-form-36 mental component score than those undergoing low anterior resection. However, 6 mo after surgery this difference was no longer statistically significant and essentially disappeared at 36 mo after surgery.CONCLUSION:Patients undergoing abdominoperineal resection for low rectal cancer have a similar long-term quality of life as those undergoing low anterior resection. These findings can help clinicians to better counsel patients with low rectal cancer who are being considered for abdominoperineal resection.

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“…This review challenged the assumption that patients who received anterior resection without colostomies universally fare better. They concluded that larger, better-designed and executed prospective studies were needed to answer this question 19 .…”

Section: Health-related Quality Of Lifementioning

confidence: 99%

The VA Ostomy Health-Related Quality of Life Study: objectives, methods, and patient sample

Krouse

Mohler

Wendel

et al. 2006

Current Medical Research and Opinion

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The unique design of our study of VA patients with ostomies is an illustration of a successful mixed methods approach to HR-QOL research. We collected meaningful quantitative and qualitative data that will be used in the development of new approaches to care that will lead to improved functioning and well-being in persons living with ostomies. Subsequent reports will provide the results of this research project.

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Quality of life after rectal resection for cancer, with or without permanent colostomy.

Cited by 102 publications

References 75 publications

Rectal cancer treatment and outcome in the elderly: an audit based on the Swedish rectal cancer registry 1995–2004

Rectal cancer treatment and outcome in the elderly: an audit based on the Swedish rectal cancer registry 1995–2004

Abdominoperineal resection does not decrease quality of life in patients with low rectal cancer

The VA Ostomy Health-Related Quality of Life Study: objectives, methods, and patient sample

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