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Quality of life in patients with loco-regional rectal cancer after ELRR by TEM versus VLS TME after nChRT: long-term results

  • 2018 EAES Oral
  • Published:
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Abstract

Background

Endoluminal loco-regional resection (ELRR) by transanal endoscopic microsurgery (TEM) may be an alternative treatment option to Laparoscopic total mesorectal excision (LTME), in selected patients with N0 rectal cancer. Post-operative quality of life (QoL) evaluation is an important parameter of outcomes related to high percentage of functional sequelae. We reported, in a previous paper, the short and medium term results of QoL in patients who underwent ELRR or LTME. The aim is to evaluate the 3 year QoL in patients with iT2–T3 N0/+ rectal cancer who underwent ELRR by TEM or LTME after neoadjuvant radio-chemotherapy (nChRT) in a retrospective analysis of prospectively collected data.

Methods

We enrolled in this study, 39 patients with iT2–T3 rectal cancer who underwent ELRR (n = 19) or LTME (n = 20), according to predefined criteria. QoL was evaluated by EORTC QLQ-C30 and QLQ-CR38 questionnaires at admission, after n-RCT and 1, 6, 12, and 36 months after surgery.

Results

No statistically significant differences in QoL evaluation were observed between the two groups, both at admission and after n-RCT. In short term (1–6 months) period, significantly better results were observed in ELRR group by QLQ-C30 in global health status (p = 0.03), physical functioning (p = 0.026), role functioning (p = 0.04), emotional functioning (p = 0.04), cognitive functioning, fatigue (p < 0.05), dyspnoea (p < 0.001), insomnia (p < 0.05), appetite loss (p < 0.05), constipation (≤ 0.05), and by QLQ-CR38 in: body image (p = 0.03) and defecation (p = 0.025). At 1 year, the two groups were homogenous as assessed by QLQ-C30, whereas the QLQCR38 still showed better results of ELRR versus LTME in body image (p = 0.006), defecation problems (p = 0.01), and weight loss (p = 0.005). At 3 years, no statistically significant differences were observed between the two groups.

Conclusions

In selected patients with rectal cancer, who underwent ELRR by TEM or LTME, QoL tests at 3 years do not show any statistical differences on examined items.

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Authors and Affiliations

  1. General and ColoRectal Surgery Division, Department of General Surgery and Surgical Specialties “Paride Stefanini”, Sapienza University of Rome, Rome, Italy

    Giancarlo D’Ambrosio, Andrea Picchetto, Francesca De Laurentis, Stefania La Rocca & Emanuele Lezoche

  2. Cardarelli Hospital, Campobasso, Italy

    Salvatore Campo

  3. Department of Surgical Sciences, “Sapienza” University of Rome, Rome, Italy

    Rossella Palma & Cristina Panetta

Authors
  1. Giancarlo D’Ambrosio
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  2. Andrea Picchetto
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  3. Salvatore Campo
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  4. Rossella Palma
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  6. Francesca De Laurentis
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  7. Stefania La Rocca
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  8. Emanuele Lezoche
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Correspondence to Andrea Picchetto.

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Disclosures

Giancarlo D’Ambrosio, Andrea Picchetto, Salvatore Campo, Rossella Palma MD, Cristina Panetta, Francesca De Laurentis, Stefania La Rocca, Emanuele Lezoche, have no conflict of interest or financial ties to disclose.

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D’Ambrosio, G., Picchetto, A., Campo, S. et al. Quality of life in patients with loco-regional rectal cancer after ELRR by TEM versus VLS TME after nChRT: long-term results. Surg Endosc 33, 941–948 (2019). https://doi.org/10.1007/s00464-018-6583-4

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