title: Quality of life among five-year survivors after treatment for very low rectal cancer with or without a permanent abdominal stoma.
abstract: BACKGROUND
  Low rectal cancers situated less than 5 cm from the anal margin are still usually treated with abdomino-perineal excision (APE). Our aim is to compare the quality of life (QOL) of five-year survivors treated for low or very low rectal cancer with an advanced/complex coloanal procedure with the QOL of patients submitted to a standard APE with a definitive abdominal stoma.
  
  
  METHODS
  Sixty-two patients, operated on radically for low or very low rectal cancer, who came for their fifth year follow-up visit and were free from cancer, were studied. Thirty patients (group 1) had an APE with permanent abdominal stoma. Thirty-two patients (group 2) had undergone a radical advanced and complex procedure to avoid the abdominal stoma. The patients received the European Organisation for the Research and Treatment of Cancer (EORTC) QOL-30 generic and the CR38 colorectal cancer QOL questionnaires with the recommendation to return the questionnaire to the hospital. The Mann-Whitney U-test and chi (2) Fisher test were employed for statistical analysis.
  
  
  RESULTS
  All questionnaires were returned. Patients without a terminal abdominal stoma had a better score in six categories of the QOL 30 and in two categories of the CR38. No differences were observed in the other variables examined.
  
  
  CONCLUSIONS
  After five years, cancer-free patients operated on for low or very low rectal cancer have a better QOL if a definitive terminal abdominal stoma was avoided.
authors.affiliation: Department of Medical and Surgical Critical Care, Section of General and Oncological Surgery, University of Florence, Viale Morgagni, 85, 50134, Firenze, Italy. claudio.fucini@unifi.it
authors.forename: C
authors.initials: C
authors.lastname: Fucini
authors.forename: R
authors.initials: R
authors.lastname: Gattai
authors.forename: C
authors.initials: C
authors.lastname: Urena
authors.forename: L
authors.initials: L
authors.lastname: Bandettini
authors.forename: C
authors.initials: C
authors.lastname: Elbetti
mesh_terms: D000368:Aged; D003082:Colectomy; D003125:Colostomy; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012004:Rectal Neoplasms / Q000601:surgery* / Q000628:therapy; D054047:Surgical Stomas; D016019:Survival Analysis