title: Baseline quality of life predicts pelvic exenteration outcome.
abstract: BACKGROUND
  Recurrent rectal cancer affects a significant group of patients with no current consensus on management. This study investigated patients' quality of life (QoL) in the 12 months after pelvic exenteration.
  
  
  METHODS
  Prospective cohort study with clinical and QoL data collected at baseline and 1, 3, 6, 9 and 12 months. QoL trajectories were modelled over 12 months from date of discharge using linear mixed models.
  
  
  RESULTS
  Of 117 patients, 93 underwent pelvic exenteration surgery, 24 did not. Thirty-day mortality was nil for both groups. For patients who had surgery, 15 (16%) died within 12 months of surgery compared with nine (38%) of the non-surgery group. Baseline QoL scores were highly variable. The non-exenteration patients' QoL gradually declined over 12 months while exenteration patients declined then recovered. Patients with high baseline QoL scores remained high, and those with low baseline QoL remained low. Baseline QoL score, gender and bony resection were significant predictors of QoL score at 12 months.
  
  
  CONCLUSIONS
  Baseline QoL is a significant, independent predictor of patients' QoL after pelvic exenteration for recurrent rectal cancer.
authors.affiliation: Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, New South Wales, Australia.
authors.forename: Ian
authors.initials: I
authors.lastname: Choy
authors.affiliation: Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, New South Wales, Australia.|School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.|RPA Institute of Academic Surgery, Sydney Local Health District, Sydney, New South Wales, Australia.
authors.forename: Jane M
authors.initials: JM
authors.lastname: Young
authors.affiliation: Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, New South Wales, Australia.|School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Tim
authors.initials: T
authors.lastname: Badgery-Parker
authors.affiliation: Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, New South Wales, Australia.
authors.forename: Lindy M
authors.identifier: http://orcid.org/0000-0003-0807-711X
authors.initials: LM
authors.lastname: Masya
authors.affiliation: Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, New South Wales, Australia.
authors.forename: Heather L
authors.initials: HL
authors.lastname: Shepherd
authors.affiliation: Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, New South Wales, Australia.
authors.forename: Cherry
authors.initials: C
authors.lastname: Koh
authors.affiliation: Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
authors.forename: Alexander G
authors.initials: AG
authors.lastname: Heriot
authors.affiliation: Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, New South Wales, Australia.|Discipline of Surgery, The University of Sydney, Sydney, New South Wales, Australia.|RPA Institute of Academic Surgery, Sydney Local Health District, Sydney, New South Wales, Australia.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Solomon
mesh_terms: D001315:Australia / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D010385:Pelvic Exenteration / Q000009:adverse effects* / Q000379:methods / Q000523:psychology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011788:Quality of Life; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
keywords: pelvic exenteration; quality of life (QoL); recurrent rectal cancer; surgery