Quality of life after surgery for rectal cancer with special reference to pelvic floor dysfunction

Varpe, Pirita; Huhtinen, Heikki; Rantala, Arto; Salminen, Paulina; Rautava, Päivi; Hurme, Saija; Grönroos, Juha

doi:10.1111/j.1463-1318.2009.02165.x

Cited by 57 publications

(38 citation statements)

References 30 publications

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“…radiotherapy and sphincter-preserving surgery the longer-term consequences of treatment are emerging. In one prospective evaluation of rectal cancer patients, the results showed that while general QoL at 1 year was similar to pre-operative levels and psychological well-being was better, there was persistent anorectal dysfunction (Varpe et al, 2011). Indeed, in a study carried out by Schmidt et al (2005) patients who had sphincter preserving surgery (anterior resection) reported poorer quality of life as a consequence of impaired bowel function, in contrast to patients receiving an abdominoperineal resection (APR).…”

Section: Discussionmentioning

confidence: 96%

Long term effect of surgery and radiotherapy for colorectal cancer on defecatory function and quality of life

Knowles

Haigh

McLean

et al. 2013

European Journal of Oncology Nursing

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Section: Discussionmentioning

confidence: 96%

Long term effect of surgery and radiotherapy for colorectal cancer on defecatory function and quality of life

Knowles

Haigh

McLean

et al. 2013

European Journal of Oncology Nursing

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“…Using the validated SF-12 questionnaire, we found that quality of life in patients following rectal cancer resection was comparable with the general population. Varpe et al used the validated RAND 36-item health survey to assess quality of life after anterior and abdominoperineal resection [23]. The authors found no difference in general quality of life before and after operation, and mental functioning showed even better results postoperatively.…”

Section: Discussionmentioning

confidence: 97%

Late pelvic function following rectal cancer resection – a case-control study

et al. 2011

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Background: There are still controversial data about the impact of rectal resection for malignancies on overall pelvic organ function and quality of life. Our aim was to investigate whether these parameters differ compared to the general population without bowel resection.Methods: One hundred eighteen patients (44%) operated for rectal cancer at a single institution between 1995 and 2005 completed a self-administering questionnaire including the International Index of Erectile Function, Female Sexual Function Index, Short Form-12 Health Survey, International Prostatic Symptom Score, International Consultation on Incontinence Questionnaire-Short Form, and Vaizey Incontinence Score.Healthy subjects with no bowel resection served as controls for each case and were matched by age (±5 years) and gender. The median follow-up time was 7 years (range 2.8-14.2).Results: The Vaizey incontinence score was significant higher in the patient group compared with the control group (patients: median 4 (range 0-24), controls: 0 (range 0-20); p < 0.0001). Sexual and urinary function showed no significant difference between both groups.In regard to the SF-12 health survey the median physical health score of patients was 51.5 (range 22.0-58.2) compared to 53.6 (range 16.8-64.3) of the control subjects (p ¼ 0.1241). The median mental health score of the patient group was 55.1 (range 19.1-63.8) compared to 55.0 (range 28.7-63.8) of the control group (p ¼ 0.2222).Conclusions: Patients with rectal cancer resection have a significant impairment of fecal continence. Notably, urinary and sexual function and quality of life are comparable with healthy subjects without colorectal resection.

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“…Additionally, sexual functioning in men was affected, often with permanent damage. 15 TAE, on the other hand, has a very low complication rate. Doornebosch et al 16 studied 50 patients, issuing them a quality of life survey before and after TAE.…”

Section: Pretreatment Differentiation (N=38)mentioning

confidence: 99%

Transanal Excision with Radiation Therapy for Rectal Adenocarcinoma

Tennyson

Mendenhall

Morris

et al. 2012

Clinical Medicine & Research

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Objective: To evaluate the efficacy of transanal excision (TAE) combined with radiotherapy for rectal adenocarcinoma, assess the ability of pretreatment endoscopic ultrasound (EUS) to predict failures, and determine the prognostic value of downstaging and complete pathological response.Design: Retrospective outcomes study. Setting: Radiation oncology clinic.Participants: Thirty-eight patients with rectal adenocarcinoma. Methods:The medical records of patients treated with radiotherapy from 1998 to 2008 and followed for a median of 5.9 years were reviewed.Results: Kaplan-Meier estimates of freedom from selected endpoints at 5 years after treatment were: overall survival, 79%; cause-specific survival, 91%; local control, 90%; and freedom from distant metastasis, 76%. Seven patients (21%) had eventual abdominoperineal resection or lower anterior resection, four patients had local recurrence, and three patients had incomplete treatment or poor margins. T3 lesions clinically staged by EUS were a predictor of local failure (P=0.0110), but not distant metastasis (P=0.35). Patients with either a pathological or clinical T3 lesion did not have a significantly greater rate of metastasis (P=0.096). Patients who were downstaged did not have a significantly different rate of local recurrence or metastasis. Patients who experienced a complete pathological response did not have a significantly different rate of local control or distant metastasis. Conclusion:Patients with early-stage rectal lesions who undergo preoperative or postoperative radiation and TAE have similar outcomes to those who undergo abdominoperineal resection; local recurrence was higher for patients with T3 lesions when both were compared. Abdominal surgery should be considered for these patients. TAE is reasonable when patients are unwilling or unable to tolerate the morbidity of traditional transabdominal surgery.

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Quality of life after surgery for rectal cancer with special reference to pelvic floor dysfunction

Abstract: Factors affecting QOL and pelvic floor function should be taken into account when making treatment decisions in rectal cancer.

Cited by 57 publications

References 30 publications

Long term effect of surgery and radiotherapy for colorectal cancer on defecatory function and quality of life

Long term effect of surgery and radiotherapy for colorectal cancer on defecatory function and quality of life

Late pelvic function following rectal cancer resection – a case-control study

Transanal Excision with Radiation Therapy for Rectal Adenocarcinoma

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