Bowel function and quality of life after local excision or total mesorectal excision following chemoradiotherapy for rectal cancer

S. Pucciarelli, F. Giandomenico, A. De Paoli, T. Gavaruzzi, L. Lotto, G. Mantello, C. Barba, P. Zotti, S. Flora, P. Del Bianco

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: Local excision for rectal cancer is expected to offer a better functional outcome than conventional surgery. The aim of the present study was to compare quality of life and bowel function in patients with rectal cancer who underwent either local excision or conventional surgery after chemoradiotherapy. Methods: This was a retrospective multicentre study. Patients who underwent local excision were compared with those who had mesorectal excision. Quality of life and bowel function were investigated using validated questionnaires (European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, EORTC QLQ-CR29 and Memorial Sloan-Kettering Cancer Center Bowel Function Instrument) at a median follow-up of 49 (range 13–95) months. Further analysis was undertaken of data from patients who underwent local excision alone compared with those requiring subsequent radical surgery. Statistical significance was set at P <0·010. Results: The mean constipation score was significantly better in the local excision group than in the mesorectal excision group (3·8 (95 per cent c.i. 0·3 to 7·2) versus 19·8 (12·1 to 27·4); P <0·001). Compared with patients who underwent mesorectal excision, those who had local excision had less sensation of incomplete emptying (mean score 3·7 (3·4 to 4·0) versus 2·8 (2·5 to 3·1); P <0·001) and second bowel movements within 15 min (mean score 3·6 (3·3 to 3·9) versus 3·0 (2·7 to 3·3); P = 0·006). Patients who underwent local excision alone scored better than those who had mesorectal excision, particularly for bowel function, who, in turn, scored better than patients requiring subsequent radical surgery following local excision. Conclusion: Patients who underwent local excision had a better quality of life and bowel function than those who underwent mesorectal excision. © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd
Original languageEnglish
Pages (from-to)138-147
Number of pages10
JournalBritish Journal of Surgery
Volume104
Issue number1
DOIs
Publication statusPublished - 2017

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Chemoradiotherapy
Rectal Neoplasms
Quality of Life
Organizations
Neoplasms
Constipation
Nuclear Family
Research
Multicenter Studies
Retrospective Studies
Therapeutics

Keywords

  • adenocarcinoma
  • adjuvant chemoradiotherapy
  • adult
  • aged
  • clinical trial
  • complication
  • constipation
  • defecation
  • feces incontinence
  • female
  • follow up
  • human
  • male
  • middle aged
  • multicenter study
  • neoadjuvant therapy
  • quality of life
  • questionnaire
  • Rectal Neoplasms
  • retrospective study
  • very elderly
  • Adenocarcinoma
  • Adult
  • Aged
  • Aged, 80 and over
  • Chemoradiotherapy, Adjuvant
  • Constipation
  • Defecation
  • Fecal Incontinence
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neoadjuvant Therapy
  • Quality of Life
  • Retrospective Studies
  • Surveys and Questionnaires

Cite this

Bowel function and quality of life after local excision or total mesorectal excision following chemoradiotherapy for rectal cancer. / Pucciarelli, S.; Giandomenico, F.; De Paoli, A.; Gavaruzzi, T.; Lotto, L.; Mantello, G.; Barba, C.; Zotti, P.; Flora, S.; Del Bianco, P.

In: British Journal of Surgery, Vol. 104, No. 1, 2017, p. 138-147.

Research output: Contribution to journalArticle

Pucciarelli, S. ; Giandomenico, F. ; De Paoli, A. ; Gavaruzzi, T. ; Lotto, L. ; Mantello, G. ; Barba, C. ; Zotti, P. ; Flora, S. ; Del Bianco, P. / Bowel function and quality of life after local excision or total mesorectal excision following chemoradiotherapy for rectal cancer. In: British Journal of Surgery. 2017 ; Vol. 104, No. 1. pp. 138-147.
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abstract = "Background: Local excision for rectal cancer is expected to offer a better functional outcome than conventional surgery. The aim of the present study was to compare quality of life and bowel function in patients with rectal cancer who underwent either local excision or conventional surgery after chemoradiotherapy. Methods: This was a retrospective multicentre study. Patients who underwent local excision were compared with those who had mesorectal excision. Quality of life and bowel function were investigated using validated questionnaires (European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, EORTC QLQ-CR29 and Memorial Sloan-Kettering Cancer Center Bowel Function Instrument) at a median follow-up of 49 (range 13–95) months. Further analysis was undertaken of data from patients who underwent local excision alone compared with those requiring subsequent radical surgery. Statistical significance was set at P <0·010. Results: The mean constipation score was significantly better in the local excision group than in the mesorectal excision group (3·8 (95 per cent c.i. 0·3 to 7·2) versus 19·8 (12·1 to 27·4); P <0·001). Compared with patients who underwent mesorectal excision, those who had local excision had less sensation of incomplete emptying (mean score 3·7 (3·4 to 4·0) versus 2·8 (2·5 to 3·1); P <0·001) and second bowel movements within 15 min (mean score 3·6 (3·3 to 3·9) versus 3·0 (2·7 to 3·3); P = 0·006). Patients who underwent local excision alone scored better than those who had mesorectal excision, particularly for bowel function, who, in turn, scored better than patients requiring subsequent radical surgery following local excision. Conclusion: Patients who underwent local excision had a better quality of life and bowel function than those who underwent mesorectal excision. {\circledC} 2016 BJS Society Ltd Published by John Wiley & Sons Ltd",
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T1 - Bowel function and quality of life after local excision or total mesorectal excision following chemoradiotherapy for rectal cancer

AU - Pucciarelli, S.

AU - Giandomenico, F.

AU - De Paoli, A.

AU - Gavaruzzi, T.

AU - Lotto, L.

AU - Mantello, G.

AU - Barba, C.

AU - Zotti, P.

AU - Flora, S.

AU - Del Bianco, P.

N1 - Cited By :4 Export Date: 15 February 2018 CODEN: BJSUA Correspondence Address: Pucciarelli, S.; Departments of Surgery, Oncology and Gastroenterology, University of PaduaItaly; email: puc@unipd.it

PY - 2017

Y1 - 2017

N2 - Background: Local excision for rectal cancer is expected to offer a better functional outcome than conventional surgery. The aim of the present study was to compare quality of life and bowel function in patients with rectal cancer who underwent either local excision or conventional surgery after chemoradiotherapy. Methods: This was a retrospective multicentre study. Patients who underwent local excision were compared with those who had mesorectal excision. Quality of life and bowel function were investigated using validated questionnaires (European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, EORTC QLQ-CR29 and Memorial Sloan-Kettering Cancer Center Bowel Function Instrument) at a median follow-up of 49 (range 13–95) months. Further analysis was undertaken of data from patients who underwent local excision alone compared with those requiring subsequent radical surgery. Statistical significance was set at P <0·010. Results: The mean constipation score was significantly better in the local excision group than in the mesorectal excision group (3·8 (95 per cent c.i. 0·3 to 7·2) versus 19·8 (12·1 to 27·4); P <0·001). Compared with patients who underwent mesorectal excision, those who had local excision had less sensation of incomplete emptying (mean score 3·7 (3·4 to 4·0) versus 2·8 (2·5 to 3·1); P <0·001) and second bowel movements within 15 min (mean score 3·6 (3·3 to 3·9) versus 3·0 (2·7 to 3·3); P = 0·006). Patients who underwent local excision alone scored better than those who had mesorectal excision, particularly for bowel function, who, in turn, scored better than patients requiring subsequent radical surgery following local excision. Conclusion: Patients who underwent local excision had a better quality of life and bowel function than those who underwent mesorectal excision. © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd

AB - Background: Local excision for rectal cancer is expected to offer a better functional outcome than conventional surgery. The aim of the present study was to compare quality of life and bowel function in patients with rectal cancer who underwent either local excision or conventional surgery after chemoradiotherapy. Methods: This was a retrospective multicentre study. Patients who underwent local excision were compared with those who had mesorectal excision. Quality of life and bowel function were investigated using validated questionnaires (European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, EORTC QLQ-CR29 and Memorial Sloan-Kettering Cancer Center Bowel Function Instrument) at a median follow-up of 49 (range 13–95) months. Further analysis was undertaken of data from patients who underwent local excision alone compared with those requiring subsequent radical surgery. Statistical significance was set at P <0·010. Results: The mean constipation score was significantly better in the local excision group than in the mesorectal excision group (3·8 (95 per cent c.i. 0·3 to 7·2) versus 19·8 (12·1 to 27·4); P <0·001). Compared with patients who underwent mesorectal excision, those who had local excision had less sensation of incomplete emptying (mean score 3·7 (3·4 to 4·0) versus 2·8 (2·5 to 3·1); P <0·001) and second bowel movements within 15 min (mean score 3·6 (3·3 to 3·9) versus 3·0 (2·7 to 3·3); P = 0·006). Patients who underwent local excision alone scored better than those who had mesorectal excision, particularly for bowel function, who, in turn, scored better than patients requiring subsequent radical surgery following local excision. Conclusion: Patients who underwent local excision had a better quality of life and bowel function than those who underwent mesorectal excision. © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd

KW - adenocarcinoma

KW - adjuvant chemoradiotherapy

KW - adult

KW - aged

KW - clinical trial

KW - complication

KW - constipation

KW - defecation

KW - feces incontinence

KW - female

KW - follow up

KW - human

KW - male

KW - middle aged

KW - multicenter study

KW - neoadjuvant therapy

KW - quality of life

KW - questionnaire

KW - Rectal Neoplasms

KW - retrospective study

KW - very elderly

KW - Adenocarcinoma

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Chemoradiotherapy, Adjuvant

KW - Constipation

KW - Defecation

KW - Fecal Incontinence

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Male

KW - Middle Aged

KW - Neoadjuvant Therapy

KW - Quality of Life

KW - Retrospective Studies

KW - Surveys and Questionnaires

U2 - 10.1002/bjs.10318

DO - 10.1002/bjs.10318

M3 - Article

VL - 104

SP - 138

EP - 147

JO - British Journal of Surgery

JF - British Journal of Surgery

SN - 0007-1323

IS - 1

ER -