title: Quality of Life After Sphincter-Preserving Rectal Cancer Resection.
abstract: BACKGROUND
  With an increasing number of cancer survivors quality of life (QoL) becomes more and more important in the treatment of rectal cancer (RC). QoL after sphincter-preserving anterior resection (AR), however, was found nonsuperior to abdominoperineal resection. The aim of our study was to evaluate QoL after AR compared with colon cancer patients after right hemicolectomy (CC) and healthy lay persons without history of cancer (HL) in long-term follow-up.
  
  
  METHODS
  Consecutive alive RC patients (n = 293) who received an AR between 1998 and 2008 were included. CC patients (n = 201) and HL of the same age were used as a surgical and a nonsurgical control group, respectively. QoL was assessed using European Organization of Research and Treatment of Cancer questionnaires QLQ-C 30 and -CR 38.
  
  
  RESULTS
  Questionnaires from 116 RC patients, 105 CC patients, and 103 HL were evaluable with a median time after surgery of 5 years. The global health status did not differ. Social functioning, future perspectives, and financial difficulties tended to poorer scores in the cancer groups. Physical functioning was better in RC and CC patients compared with HL. Defecation problems and diarrhea were more frequent in RC patients (P < .05). An additional open question revealed a median stool frequency of 3, 2, and 1 per day for RC, CC, and HL, respectively. Defecation problems were more frequent in RC patients who received radiation therapy (P < .05).
  
  
  CONCLUSIONS
  Diarrhea and defecation problems impaired QoL after AR for RC, which was worsened after radiation therapy. To improve QoL of RC patients in the future, physicians have to focus on minimization of gastrointestinal side effects while optimizing surgical reconstruction.
authors.affiliation: Clinic of General and Visceral Surgery, University of Ulm, Ulm, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Scheele
authors.affiliation: Clinic of General and Visceral Surgery, University of Ulm, Ulm, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Lemke
authors.affiliation: Clinic of General and Visceral Surgery, University of Ulm, Ulm, Germany.
authors.forename: Marcus
authors.initials: M
authors.lastname: Meier
authors.affiliation: Institute for Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany.
authors.forename: Silvia
authors.initials: S
authors.lastname: Sander
authors.affiliation: Clinic of General and Visceral Surgery, University of Ulm, Ulm, Germany.
authors.forename: Doris
authors.initials: D
authors.lastname: Henne-Bruns
authors.affiliation: Clinic of General and Visceral Surgery, University of Ulm, Ulm, Germany. Electronic address: marko.kornmann@uniklinik-ulm.de.
authors.forename: Marko
authors.initials: M
authors.lastname: Kornmann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000601:surgery*; D003082:Colectomy / Q000379:methods*; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D003672:Defecation; D003967:Diarrhea / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D059351:Organ Sparing Treatments; D011788:Quality of Life; D012004:Rectal Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D011795:Surveys and Questionnaires
keywords: Anterior resection; Functional outcome; Hemicolectomy; Lay persons; QoL