Quality of life after surgery in individuals with familial colorectal cancer: does extended surgery have an adverse impact?
BACKGROUND
There is controversy regarding the optimum surgical treatment of patients presenting with colorectal cancer with known or suspected genetic cancer syndromes. Although standard segmental resection may be curative, a high risk of metachronous malignancy leads many to advocate extended surgery. The current study was designed to assess whether or not extended surgery adversely impacts quality of life compared to segmental surgery.


METHODS
Records at The Royal Melbourne Hospital Family Cancer Clinic were searched in order to identify patients with suspected high risk familial colon cancer. Patients who underwent surgery were identified and mailed two Standardized Quality of Life Questionnaires (EORTC QLQ-C30 and EORTC QLQ-CR38).


RESULTS
Fifty respondents met the inclusion criteria. None of the 15 patients whose primary operation was an extended procedure developed a metachronous cancer. Seventeen of the 35 (48.67%) who had an initial segmental resection had subsequent surgery for metachronous cancer. At the time of the questionnaire, 27 had extended surgery and 23 had segmental operations. The overall global health status and quality of life was very similar between the two groups.


CONCLUSIONS
This study confirms that there is a high rate of metachronous cancer for patients undergoing segmental resection for hereditary colon cancer. Quality of life following either segmental or extended resection is not significantly different. Consequently, it is reasonable to recommend extended surgery for most patients with high risk hereditary colon cancer.
Department of Surgery, St. Clare's Mercy Hospital, St. John's, Newfoundland, Canada.
William G
WG
Pollett
Kaye
K
Marion
Gabriela
G
Moeslein
Claudia
C
Schneider
Susan
S
Parry
Katrina
K
Veysey
Ian P
IP
Bissett
Ian
I
Jones
Finlay
F
Macrae
D015179:Colorectal Neoplasms / Q000235:genetics* / Q000601:surgery*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D016609:Neoplasms, Second Primary / Q000601:surgery; D011788:Quality of Life
colectomy; colorectal surgery; familial colon cancer; quality of life; surgical oncology