title: Health-related quality of life, faecal continence and bowel function in rectal cancer patients after chemoradiotherapy followed by radical surgery.
abstract: 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.
authors.affiliation: Department of Oncological and Surgical Sciences, 2nd Surgical Clinic, University of Padova, Clinica Chirurgica II, Policlinico, VI piano, 35128 Padova, Italy. puc@unipd.it
authors.forename: Salvatore
authors.initials: S
authors.lastname: Pucciarelli
authors.forename: Paola
authors.initials: P
authors.lastname: Del Bianco
authors.forename: Fabio
authors.initials: F
authors.lastname: Efficace
authors.forename: Paola
authors.initials: P
authors.lastname: Toppan
authors.forename: Samantha
authors.initials: S
authors.lastname: Serpentini
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Friso
authors.forename: Sara
authors.initials: S
authors.lastname: Lonardi
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: De Salvo
authors.forename: Donato
authors.initials: D
authors.lastname: Nitti
mesh_terms: 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*