Health-related quality of life, faecal continence and bowel function in rectal cancer patients after chemoradiotherapy followed by radical surgery.
OBJECTIVE
To evaluate health-related quality of life (HRQOL), faecal continence and bowel function of patients with rectal cancer who underwent preoperative chemoradiotherapy (pCRT) in a cross-sectional setting.


METHODS
Out of 185 consecutive patients who underwent pCRT for rectal cancer from 1994 to 2004 at a single institution, 101 were eligible for the study. Causes of exclusion were: death (n = 38), not radical surgery or recurrence (n = 21), presence of stoma at the time of the survey (n = 15), lost to follow-up (n = 6) and miscellaneous (n = 4). Eligible patients were asked to complete: the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30, the disease specific colorectal module (EORTC QLQ-CR38) and faecal incontinence and bowel function questionnaires. HRQOL outcomes were compared with reference data from the general population, and the association among clinical variables and HRQOL was also investigated with linear regression analyses.


RESULTS
Questionnaires were completed by 80% of eligible patients. Compared to population-based norms, patients showed clinically meaningful worse outcomes in terms of constipation and diarrhoea. Stool fractionation (p < 0.01) and use of enema/laxative (p < 0.01) were negatively associated with global health status/QOL. Urgency negatively affected physical (p < 0.01), role (p < 0.01) and social functioning (p < 0.01). Sensation of incomplete evacuation negatively affected social functioning (p < 0.01).


CONCLUSIONS
Although HRQOL profile of these patients is broadly similar to that of healthy subjects, there are still important limitations in terms of key symptoms. The use of validated questionnaires is crucial to provide standardised information on relevant health status areas.
Pucciarelli
Salvatore
S
Department of Oncological and Surgical Sciences, 2nd Surgical Clinic, University of Padova, Clinica Chirurgica II, Policlinico, VI piano, 35128 Padova, Italy. puc@unipd.it
Del Bianco
Paola
P
Efficace
Fabio
F
Toppan
Paola
P
Serpentini
Samantha
S
Friso
Maria Luisa
ML
Lonardi
Sara
S
De Salvo
Gian Luca
GL
Nitti
Donato
D
D000368:Aged; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D003430:Cross-Sectional Studies; D005242:Fecal Incontinence / Q000209:etiology*; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*