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Health-related quality of life, faecal continence and bowel function in rectal cancer patients after chemoradiotherapy followed by radical surgery

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Abstract

Purpose

To evaluate health-related quality of life (HRQOL), faecal continence and bowel function of patients with rectal cancer who underwent preoperative chemoradiotherapy (pCRT) in a cross-sectional setting.

Methods

Out of 185 consecutive patients who underwent pCRT for rectal cancer from 1994 to 2004 at a single institution, 101 were eligible for the study. Causes of exclusion were: death (n = 38), not radical surgery or recurrence (n = 21), presence of stoma at the time of the survey (n = 15), lost to follow-up (n = 6) and miscellaneous (n = 4). Eligible patients were asked to complete: the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30, the disease specific colorectal module (EORTC QLQ-CR38) and faecal incontinence and bowel function questionnaires. HRQOL outcomes were compared with reference data from the general population, and the association among clinical variables and HRQOL was also investigated with linear regression analyses.

Results

Questionnaires were completed by 80% of eligible patients. Compared to population-based norms, patients showed clinically meaningful worse outcomes in terms of constipation and diarrhoea. Stool fractionation (p < 0.01) and use of enema/laxative (p < 0.01) were negatively associated with global health status/QOL. Urgency negatively affected physical (p < 0.01), role (p < 0.01) and social functioning (p < 0.01). Sensation of incomplete evacuation negatively affected social functioning (p < 0.01).

Conclusions

Although HRQOL profile of these patients is broadly similar to that of healthy subjects, there are still important limitations in terms of key symptoms. The use of validated questionnaires is crucial to provide standardised information on relevant health status areas.

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Authors and Affiliations

  1. Department of Oncological and Surgical Sciences, 2nd Surgical Clinic, University of Padova, Clinica Chirurgica II, Policlinico, VI piano, Via Giustiniani, 2, 35128, Padova, Italy

    Salvatore Pucciarelli, Paola Toppan, Samantha Serpentini & Donato Nitti

  2. Servizio Sperimentazioni Cliniche e Biostatistica, Istituto Oncologico Veneto-IRCCS, Padova, Italy

    Paola Del Bianco & Gian Luca De Salvo

  3. Health Outcomes Research Unit, Gruppo Italiano Malattie Ematologiche dell’Adulto (GIMEMA), GIMEMA Data Centre, Rome, Italy

    Fabio Efficace

  4. Department of Radiotherapy, Istituto Oncologico Veneto-IRCCS, Padova, Italy

    Maria Luisa Friso

  5. Department of Oncology, Istituto Oncologico Veneto-IRCCS, Padova, Italy

    Sara Lonardi

Authors
  1. Salvatore Pucciarelli
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  2. Paola Del Bianco
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  3. Fabio Efficace
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  4. Paola Toppan
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  5. Samantha Serpentini
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  6. Maria Luisa Friso
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  7. Sara Lonardi
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  8. Gian Luca De Salvo
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  9. Donato Nitti
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Corresponding author

Correspondence to Salvatore Pucciarelli.

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Pucciarelli, S., Del Bianco, P., Efficace, F. et al. Health-related quality of life, faecal continence and bowel function in rectal cancer patients after chemoradiotherapy followed by radical surgery. Support Care Cancer 18, 601–608 (2010). https://doi.org/10.1007/s00520-009-0699-y

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  • DOI: https://doi.org/10.1007/s00520-009-0699-y

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