1. Digestive and genitourinary sequelae in rectal cancer survivors and their impact on health-related quality of life: Outcome of a high-resolution population-based study
- Author
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Guy Samama, Frédéric Genuist, Karine Bouhier-Leporrier, Jaroslaw Chomontovski, Laurent Mosquet, Denis Mauger, Marine Renier, Michel Cojocaru, Denis No Mura, Lakhdar Saadi, Jacques Soufron, Demetrios Koutsomanis, Cécile Bonnamy, Stéphane Corbinais, Antoine Granveau, Morgane Finochi, Yannick Le Roux, Claudine Lepoittevin, Daniel Cohen, Véronique Bouvier, Jean-Pierre Toudic, Emmanuel Polycarpe, Sylvain Auvray, Christelle Lartigau, Richard Barthélémy, Cyprien Rodriguez, Patrice Marchand, Jean-Marc Guilloit, Gil Lebreton, Joséphine Gardy, André L’Hirondel, Didier Reijasse, Eric Kalinski, Romain Gloro, Marie-Pierre Galais, Bernard Apoil, Guy Launoy, Dominique Arsène, Nathan Dolet, Florence Polycarpe, Olivier Dejardin, Eric Borotto, Jean-Pierre Desfachelles, Thierry Collet, Rémy Morello, Laurent Lagriffoul, Eric Degoutte, Yoann Marion, Jacques Jacob, Farouk Sleman, Franck Siriser, Catherine Renet, Barbara Alkofer, Aurélie Parzy, Benoit Dupont, Philippe Armand, Jean-Louis Brefort, Ammar Makki, Anne Laure Bignon, Arnaud Alves, Alexandre Thobie, Jean Michel Ollivier, Patrick Congard, Sophie Hervé, Laurent Lechevallier, Laurent-Eric Tiengou, Denis Lefrançois, Mehdi Hessissen, Marc Couque, Julien Leporrier, Nicolas Girard, Anne-Charlotte Lefebvre, Yves Teste, Laurent Lion, Céline Bazille, Louis Paul Argouarch, Amar Abdelli, Christian L’Hirondel, Y. Eid, Benjamin Menahem, Samouh Elfadel, Mihaela Saplacan, Marie-Vincent Ahkong, Service de Chirurgie Viscérale et Digestive [CHU Caen], CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers (ANTICIPE), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de Biostatistique et de Recherche Clinique (UBRC), and Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)
- Subjects
Male ,medicine.medical_specialty ,Cross-sectional study ,Colorectal cancer ,[SDV]Life Sciences [q-bio] ,Digestive System Diseases ,Population ,030230 surgery ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Cancer Survivors ,Male Urogenital Diseases ,Internal medicine ,Surveys and Questionnaires ,medicine ,Humans ,Registries ,education ,Aged ,education.field_of_study ,Genitourinary system ,business.industry ,Rectal Neoplasms ,Middle Aged ,medicine.disease ,Combined Modality Therapy ,Female Urogenital Diseases ,3. Good health ,Cross-Sectional Studies ,030220 oncology & carcinogenesis ,Population Surveillance ,Cohort ,Quality of Life ,Surgery ,International Prostate Symptom Score ,Female ,Sexual function ,business ,Follow-Up Studies - Abstract
Background With the rising number of rectal cancer survivors, more patients with sphincter-preserving surgery are having to live with a potentially impaired quality of life. The survey aimed to assess bowel and genitourinary sequelae and their impact on quality of life in an unselected registry-based population of rectal cancer survivors. Methods This cross-sectional cohort survey (registered at ClinicalTrials.gov ; ID: NCT03459235 ) included patients with rectal cancer who underwent curative surgery with sphincter-preserving surgery from January 1, 2007 to January 31, 2015. Patients with recurrent disease, intestinal stoma, or cognitive disorders were excluded. Validated scoring system included the Urinary Symptom Profile in women and the International Prostate Symptom Score in men for urinary function, International Index for Erectile Function 5 in men and Female Sexual Function Index in women for sexual function, and Core 30/ Colo Rectal 29 questionnaires for quality of life and Low Anterior Resection Syndrome score for bowel function. The impact of functional sequelae on global quality of life was evaluated by multiple linear regression. Results Responders (45.3%, 92/203 patients) and nonresponders were comparable according to sex, age, tumor stage, and neoadjuvant chemoradiation. With a mean follow-up of 6.5 years, 65.2% of the rectal cancer survivors had bowel dysfunction, of whom 41.3% experienced major Low Anterior Resection Syndrome and 80% of rectal cancer survivors experienced genitourinary dysfunction. In multiple linear regression, poor bowel function was a significant predictor of global quality of life in men (P = .04) and women (P = .0003). Conclusion This survey highlights the importance of sexual and bowel dysfunction in rectal cancer survivors and the strong correlation between high Low Anterior Resection Syndrome score and inferior quality of life. Further studies are needed to improve knowledge on how to predict bowel dysfunction and how to best support patients with bowel dysfunction.
- Published
- 2019