Comparison of quality of life, symptom and functional outcomes following surgical treatment for colorectal neoplasia
- PMID: 37173802
- DOI: 10.1111/ans.18510
Comparison of quality of life, symptom and functional outcomes following surgical treatment for colorectal neoplasia
Abstract
Background: Colorectal surgical procedures can have a significant impact on quality-of-life (QoL), functional and symptom outcomes. This retrospective study conducted in a tertiary care center evaluated the influence of four colorectal surgical procedures on patient-reported outcome measures (PROMs).
Methods: 512 patients undergoing colorectal neoplasia surgery between June 2015 and December 2017 were identified via the Cabrini Monash Colorectal Neoplasia database. Primary outcomes measured were the mean changes in PROMs following surgery utilizing the International Consortium of Health Outcome Measures colorectal cancer (CRC) PROMs.
Results: 242 patients from 483 eligible patients responded (50% participation rate). Responders and non-responders were comparable in median age (72 vs. 70 years), gender (48% vs. 52% male), time from surgery (<1 and >1 year), overall stage at diagnosis and type of surgery. Respondents underwent either a right hemicolectomy, ultra-low anterior resection, abdominoperineal resection or a transanal endoscopic microsurgery/transanal minimally invasive surgery. Right hemicolectomy patients reported the best post-operative function and reduced symptoms, significantly better (P < 0.01) than ultra-low anterior resection patients who reported the worst outcomes in multiple areas (body image, embarrassment, flatulence, diarrhoea, stool frequency). Furthermore, patients undergoing an abdominoperineal resection reported the worst scores for body image, urinary frequency, urinary incontinence, buttock pain, faecal incontinence and male impotence.
Conclusions: The differences in PROMs in CRC surgical procedures is demonstrable. The worst post-operative functional and symptom scores were reported after either an ultra-low anterior resection or an abdominoperineal resection. Implementation of PROMs will identify and aid early patient referral to allied health and support services.
Keywords: colorectal cancer; patient-reported outcome measures; quality of life; surgery.
© 2023 Royal Australasian College of Surgeons.
References
-
- Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin. 2018; 68: 394-424.
-
- Zerillo JA, Schouwenburg MG, van Bommel ACM et al. An international collaborative standardizing a comprehensive patient-centered outcomes measurement set for colorectal cancer. JAMA Oncol. 2017; 3: 686-94.
-
- Hendren SK, O'Connor BI, Liu M et al. Prevalence of male and female sexual dysfunction is high following surgery for rectal cancer. Ann. Surg. 2005; 242: 212-23.
-
- Sun R, Dai Z, Zhang Y, Lu J, Zhang Y, Xiao Y. The incidence and risk factors of low anterior resection syndrome (LARS) after sphincter-preserving surgery of rectal cancer: a systematic review and meta-analysis. Support Care Cancer 2021; 29: 7249-58.
-
- van Gijn W, Marijnen CA, Nagtegaal ID et al. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicentre, randomised controlled TME trial. Lancet Oncol. 2011; 12: 575-82.
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources
Medical