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Patient‐centered outcomes to decide treatment strategy for patients with low rectal cancer
Author(s) -
Honda Michitaka,
Akiyoshi Takashi,
Noma Hisashi,
Ogura Atsushi,
Nagasaki Toshiya,
Konishi Tsuyoshi,
Fujimoto Yoshiya,
Nagayama Satoshi,
Fukunaga Yosuke,
Ueno Masashi
Publication year - 2016
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24376
Subject(s) - medicine , abdominoperineal resection , anus , fecal incontinence , quality of life (healthcare) , patient centered outcomes , colorectal cancer , chemoradiotherapy , surgery , cancer , overall survival , nursing
Background For patients with low‐lying rectal cancer, the feasibility of anus‐preserving surgery in combination with neoadjuvant chemoradiotherapy (NACRT) has been not well established from the perspective of patient‐centered outcomes. Methods We investigated 278 patients with low‐lying rectal adenocarcinoma from 2005 to 2012. We compared their symptoms and QOL scores of patients who underwent anus‐preserving surgery with (n = 88) and without (n = 143) NACRT according to the Wexner scale, EORTC QLQ C‐30, CR29, and the modified fecal incontinence quality life scale (mFIQL). Furthermore, to assess the rationale for intersphincteric resection (ISR) with NACRT, we also compared QOL of patients who underwent ISR with NACRT (n = 31) and abdominoperineal resection (APR, n = 47). Results The adjusted mean differences of the Wexner score estimates of the patients who underwent ISR and very low anterior resection (VLAR) with or without NACRT were 5.29 ( P = 0.004) and 2.67 ( P = 0.009), respectively. No significant difference was observed in the QOL scores of two treatment groups. Furthermore, there were no significant differences in the QOL or function scores of patients who underwent ISR with NACRT and APR. Conclusion The incontinence was significantly worse in patients who receive NACRT. However, there were no significant differences in their QOL or function scores. J. Surg. Oncol. 2016;114:630–636 . © 2016 Wiley Periodicals, Inc.