title: A longitudinal study of gender differences in quality of life among Japanese patients with lower rectal cancer treated with sphincter-saving surgery: a 1-year follow-up.
abstract: BACKGROUND
  Up to 80% of patients with rectal cancer undergo sphincter-saving surgery, and almost 90% of them experience subsequent physical changes. The number of studies on gender differences in response to this surgery has increased, and the connection between gender and symptoms and patient outcomes has generated increasing interest. Nevertheless, little is known about the gender differences in quality of life and cancer-related symptoms. We examined gender differences and quality of life changes over a 1-year period among patients with lower rectal cancer who were treated with sphincter-saving surgery.
  
  
  METHODS
  Patients (men = 42; women = 33) completed a self-administered questionnaire on their quality of life and related factors before surgery and 1, 6, and 12 months afterwards. The questionnaire was developed by the European Organization for Research and Treatment of Cancer (EORTC QLQ-C30/CR-38).
  
  
  RESULTS
  Scores on physical, role, and social functioning and global health status/quality of life decreased 1 month after surgery, improved after 6 months, and returned to baseline within 12 months, with the exception of social functioning in men. Factors related to quality of life changed after surgery and differed between men and women. Women's global health status/quality of life was affected by fatigue, weight loss, defecation problems, and future perspective, while that of men was affected by fatigue, weight loss, future perspective, and role functioning, which was affected by pain, defecation problems, and financial difficulties.
  
  
  CONCLUSIONS
  Gender differences should be considered when predicting the quality of life of cancer patients undergoing surgery. Identifying gender differences will help health care providers anticipate the unique needs of patients undergoing surgery for rectal cancer.
authors.affiliation: Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. kino@hs.med.kyushu-u.ac.jp.
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Kinoshita
authors.affiliation: Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. chishaki@hs.med.kyushu-u.ac.jp.
authors.forename: Akiko
authors.initials: A
authors.lastname: Chishaki
authors.affiliation: Japanese Nursing Association, 5-8-2 Jingu-mae, Shibuya-ku, Tokyo, 150-0001, Japan. rieko.kawamoto@nurse.or.jp.
authors.forename: Rieko
authors.initials: R
authors.lastname: Kawamoto
authors.affiliation: Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. manabe@surg1.med.kyushu-u.ac.jp.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Manabe
authors.affiliation: Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. tueki@surg1.med.kyushu-u.ac.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Ueki
authors.affiliation: International University of Health and Welfare, 1-7-4 Momochihama, Sawara-ku, Fukuoka, 814-0001, Japan. hirata@kouhoukai.or.jp.
authors.forename: Keiji
authors.initials: K
authors.lastname: Hirata
authors.affiliation: School of Nursing, Fukuoka Prefectural University, 4395 Ita, Tagawa-city, Fukuoka, 825-8585, Japan. miyazono@fukuoka-pu.ac.jp.
authors.forename: Mami
authors.initials: M
authors.lastname: Miyazono
authors.affiliation: Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. kanaoka@hs.med.kyushu-u.ac.jp.
authors.forename: Maki
authors.initials: M
authors.lastname: Kanaoka
authors.affiliation: Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. tomioka@hs.med.kyushu-u.ac.jp.
authors.forename: Akiko
authors.initials: A
authors.lastname: Tomioka
authors.affiliation: Department of Nursing, Junshin Gakuen University, 1-1-1 Chikushigaoka, Minami-ku, Fukuoka, 815-8510, Japan. nakano.m@junshin-u.ac.jp.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nakano
authors.affiliation: Kirameki Project Carrier Support Center, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. ohkusa@kirameki.med.kyushu-u.ac.jp.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Ohkusa
authors.affiliation: Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. hnakao@hs.med.kyushu-u.ac.jp.
authors.forename: Hisako
authors.initials: H
authors.lastname: Nakao
authors.affiliation: Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. masaotan@surg1.med.kyushu-u.ac.jp.
authors.forename: Masao
authors.initials: M
authors.lastname: Tanaka
authors.affiliation: International University of Health and Welfare, 1-7-4 Momochihama, Sawara-ku, Fukuoka, 814-0001, Japan. mibu@kouhoukai.or.jp.
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Mibu
mesh_terms: D001003:Anal Canal / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D059351:Organ Sparing Treatments / Q000379:methods*; D011379:Prognosis; D011788:Quality of Life; D012004:Rectal Neoplasms / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D012737:Sex Factors; D011795:Surveys and Questionnaires