Bowel dysfunction after low anterior resection with and without neoadjuvant therapy for rectal cancer: a population-based cross-sectional study

Sidse Bregendahl, Katrine Emmertsen, Jørgen Lous, Søren Laurberg

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Aim: Bowel dysfunction was assessed after low anterior resection with and without neoadjuvant therapy (NT) for rectal cancer using a novel symptom-based scoring system correlated with quality of life. Method: We identified all patients who underwent curative resection for rectal cancer in Denmark between 2001 and 2007. A questionnaire on bowel function and quality of life, including the recently validated low anterior resection syndrome score (LARS score; range 0-42) was administered to recurrence-free patients in 2009. We used multivariate analysis to examine the association between major LARS (LARS score ≥ 30) and a number of patient and treatment-related factors. Results: Of 1087 eligible patients, 980 agreed to participate and, of these, 938 were included in the analysis. Major LARS was observed in 41%. The use of NT (OR = 2.48; 95% CI: 1.73-3.55), long-course chemoradiotherapy vs short-course radiotherapy (OR = 0.90; 95% CI: 0.44-1.87), total mesorectal excision (TME) vs partial mesorectal excision (PME) (OR = 2.31; 95% CI: 1.69-3.16), anastomotic leakage (OR = 2.06; 95% CI: 0.93-4.55), age ≤ 64 years at surgery (OR = 1.90; 95% CI: 1.43-2.51) and female gender (OR = 1.35; 95% CI 1.02-1.79) were associated with major LARS. No association was found between major LARS and the time since surgery (OR = 0.78; 95% CI: 0.59-1.04) or neorectal reconstruction (colonic pouch vs straight colorectal or side-to-end anastomosis (OR = 0.96; 95% CI: 0.63-1.46). Conclusion: Severe bowel dysfunction is a frequent long-term outcome after resection for rectal cancer. Use of NT, regardless of a long- or short-course protocol, and TME (compared with PME) are strong independent risk factors for major LARS.

Translated title of the contributionDårlig tarmfunktion efter operation for rektum kræft med og uden tillægsbehandling.
Original languageEnglish
JournalColorectal Disease
Volume15
Issue number9
Pages (from-to)1130-1139
ISSN1462-8910
DOIs
Publication statusPublished - 2013

Keywords

  • Bowel dysfunction
  • Long-course chemoradiotherapy
  • Partial mesorectal excision
  • Rectal cancer
  • Short-course radiotherapy
  • Total mesorectal excision

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