Long-term outcomes and quality of life after rectal carcinoma surgery

Br J Surg. 2010 Aug;97(8):1295-303. doi: 10.1002/bjs.7105.

Abstract

Background: A cohort study was undertaken to investigate the long-term oncological outcome, late adverse effects and quality of life (QOL) after treatment for rectal cancer.

Methods: This was an analysis of prospectively collected data from 268 consecutive patients with rectal carcinoma treated between 1995 and 1997 at the Department of Surgery, University Hospital Erlangen, Germany.

Results: Median follow-up was 8.8 years. The overall 10-year survival rate was 48.1 per cent. Of 219 patients who had a curative resection, 67 developed recurrent disease and 13 had second malignancies. Seventy patients had either a permanent stoma or a late adverse effect. Anorectal dysfunction and small bowel obstruction were significantly more common among patients who had multimodal treatment (P < 0.001 and P = 0.049 respectively). Analysis of QOL in 97 long-term survivors showed that receiving chemoradiotherapy, a permanent stoma and lower-third rectal carcinoma were associated with significantly worse outcomes on several measures.

Conclusion: Late adverse effects and recurrences occurred in a significant number of patients during long-term follow-up. QOL varied according to tumour location and treatment type.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Disease-Free Survival
  • Female
  • Humans
  • Ileostomy / statistics & numerical data
  • Kaplan-Meier Estimate
  • Male
  • Neoplasms, Multiple Primary / mortality
  • Neoplasms, Multiple Primary / surgery
  • Postoperative Complications / etiology
  • Postoperative Complications / mortality
  • Postoperative Complications / surgery
  • Prospective Studies
  • Quality of Life*
  • Rectal Neoplasms / mortality
  • Rectal Neoplasms / surgery*
  • Reoperation / statistics & numerical data
  • Treatment Outcome