[Influence of adjuvant radio-chemotherapy for rectal cancer on quality of life].
BACKGROUND
Modern therapy for rectal cancer is associated with functional disorders. Dysfunction as a consequence of surgery has to be distinguished from disorders caused by postoperative therapy. Therefore we have compared the long-term functional results of patients who received postoperative radio-chemotherapy or no therapy in conjunction with low anterior resection of the rectum.


METHODS
From 1997 to 2002, a total of 32 patients (16 males and 16 females) after low anterior rectal resection and postoperative radio-chemotherapy or surgical therapy alone was compared using standardized and validated instruments (Short-Form-36-Health-Survey, EORTC QLQ-C30, QLQ-CR 38 and ASCRS fecal incontinence questionnaire) in a matched-pair analysis (age, gender and time of surgery). Mean age was 61.8 (62.1) years and mean follow-up was 4 (3.8) years.


RESULTS
Two out of the 40 examined parameters differed significantly. There were no significant differences in Short-Form-36-Health-Survey and EORTC QLQ-C30 scales between both groups. The QLQ-CR38 scale sexual enjoyment differed significantly, whereas future perspectives, sexual functioning, micturition problems, symptoms in the area of the gastrointestinal tract, weight loss, defecation problems, male and female sexual problems did not differ significantly. The scales Lifestyle, Coping/Behavior and Depression/Self-Perception of the ASCRS fecal incontinence questionnaire also did not differ significantly. The difference for embarrassment was significant.


CONCLUSIONS
No differences in quality of life after postoperative radio-chemotherapy or no postoperative therapy in conjunction with low anterior rectal resection can be found. There are, however, tendencies that postoperative radio-chemotherapy has more adverse effects on continence and sexual function than low anterior rectal resection alone.
Fischer
F
F
Klinik für Chirurgie, Universitätsklinikum Schleswig Holstein, Campus Lübeck. Fischer_F@web.de
Mirow
L
L
Gondeck
C
C
Schwandner
O
O
Bruch
H-P
HP
Farke
S
S
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant / Q000706:statistics & numerical data; D015897:Comorbidity; D005242:Fecal Incontinence / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011182:Postoperative Care / Q000706:statistics & numerical data*; D011379:Prognosis; D011788:Quality of Life; D011878:Radiotherapy / Q000706:statistics & numerical data*; D018714:Radiotherapy, Adjuvant / Q000706:statistics & numerical data; D012004:Rectal Neoplasms / Q000453:epidemiology* / Q000628:therapy*; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D016896:Treatment Outcome
D000970:Antineoplastic Agents