Does Extended Surgery Influence Health-Related Quality of Life in Patients With Rectal Cancer?. Issue 2 (February 2015)

• Record Type: Journal Article
• Authors: Orsini, Ricardo G.; Vermeer, Thomas A.; Traa, Marjan J.; Nieuwenhuijzen, Grard A. P.; de Hingh, Ignace H. J. T.; Rutten, Harm J. T.
• Is Part Of: Diseases of the colon & rectum. Volume 58:Issue 2(2015:Feb.)
• Publication Date: 2015-02
• Subjects: Colon (Anatomy) -- Diseases -- Periodicals; Rectum -- Diseases -- Periodicals; Colonic Diseases -- Periodicals; Colorectal Surgery -- Periodicals; 616.34
• DOI: 10.1097/DCR.0000000000000292
• Languages: English
• ISSNs: 0012-3706

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>BACKGROUND:</title> <p>In locally advanced rectal cancer, an extended resection peripheral to the mesorectal fascia is needed to achieve a radical resection. The influence of extended resections on health-related quality of life is unclear.</p> </sec> <sec> <title>OBJECTIVE:</title> <p>Differences in health-related quality of life and sexuality between patients receiving standard surgery and patients receiving extended surgery were examined, with a focus on age.</p> </sec> <sec> <title>DESIGN:</title> <p>Patients operated on for rectal cancer between 2000 and 2010 were selected from a database and invited to complete the European Organization for Research and Treatment of Cancer quality-of-life questionnaires (C30 and ColoRectal 38).</p> </sec> <sec> <title>SETTINGS:</title> <p>All patients were treated at the Catharina Hospital, Eindhoven, the Netherlands.</p> </sec> <sec> <title>PATIENTS:</title> <p>All patients received total mesorectal excision surgery or extended surgery for rectal cancer.</p> </sec> <sec> <title>MAIN OUTCOME MEASURES:</title> <p>Health-related quality of life and sexual activity was compared between patients treated with total mesorectal excision surgery and extended surgery and further stratified by age at the time of surgery (<70 and ≥70).</p> </sec> <sec> <title>RESULTS:</title> <p>Two hundred twenty-nine (64.1%) patients with standard surgery and 128 (35.9%) patients treated with extended resections responded. Extended surgery in patients <70 years resulted in lower body image compared with patients <70 years receiving standard surgery. Patients ≥70 years had lower sexual function and more male sexual dysfunction than patients <70 years undergoing standard surgery. In all groups, sexual activity dropped significantly after treatment.</p> </sec> <sec> <title>LIMITATIONS:</title> <p>No information was available of the patients' health-related quality of life before treatment except for the retrospective question about sexual activity.</p> </sec> <sec> <title>CONCLUSIONS:</title> <p>This study showed no major differences between patients undergoing total mesorectal excision surgery and those receiving extended surgery, with the exception of body image, which was significantly lower in patients <70 years undergoing extended surgery. In all patient groups, treatment for rectal cancer influenced sexual activity dramatically. Awareness of the impact of surgery on health-related quality of life and sexuality is needed.</p> </sec> </abstract>