Skip to main content
Top
Published in: Clinical and Translational Oncology 10/2019

01-10-2019 | Enterostomy | Research Article

Comparison of overall survival and quality of life between patients undergoing anal reconstruction and patients undergoing traditional lower abdominal stoma after radical resection

Authors: P. Du, S.-Y. Wang, P.-F. Zheng, J. Mao, H. Hu, Z.-B. Cheng

Published in: Clinical and Translational Oncology | Issue 10/2019

Login to get access

Abstract

Background

Miles procedure is often necessary for patients with low rectal carcinoma. However, this operation often affects the quality of life of patients, to evaluate the advantages of improved operation (anal reconstruction), the quality of life and survival between patients undergoing anal reconstruction and patients undergoing traditional lower abdominal stoma after radical resection were analyzed.

Methods

The clinical data of 43 patients with low situated rectal carcinoma were retrospectively analyzed. 23 patients with left lower abdominal stoma after radical resection (Miles procedure) were divided into group A, and 20 patients with reconstruction of the anus in situ after radical resection were in group B. All patients were investigated by the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-CR38 questionnaire, the clinical data are recorded. Independent sample T test was used to analyze the difference in quality of life between group A and group B at 3, 6, and 12 months after surgery, and Kaplan–Meier was used to compare the difference in overall survival between group A and group B.

Results

The results of T test showed that there were statistical significance in global health status and physical functioning between group A and group B at 3 and 6 months, but no statistical significance at 12 months (P = 0.024, P = 0.019, P = 0.115 for global health status; P = 0.004, P = 0.006, P = 0.065 for physical functioning, respectively). Emotional functioning and social functioning were also statistically significant between group A and group B at 3, 6, and 12 months (P = 0.041, P = 0.040, P = 0.034 for Emotional functioning; P = 0.020, P = 0.009, P = 0.032 for social functioning, respectively). This study also found that there was no statistical significance in body image and sexual functioning between group A and group B at 3 months, but there was statistical significance at 6 and 12 months(P = 0.098, P = 0.035, P = 0.045 for body image; P = 0.110, P = 0.048, P = 0.047 for sexual functioning, respectively). There were statistically significant about sexual enjoyment and defecation problems at 3, 6, and 12 months (P = 0.023, P = 0.028, P = 0.050 for sexual enjoyment; P = 0.013, P = 0.011, P = 0.050 for defecation problems, respectively).The results of Kaplan–Meier showed that the overall survival (OS) between group A and group B was not statistically significant (χ2 = 0.600, P = 0.439).

Conclusions

There was no difference in survival time between group A and group B, but compared with the patients with left lower abdominal stoma(group A), the quality of life was better in patients with reconstruction of the anus in situ (group B). It is significant to improve the traditional lower abdominal stoma operation.

Literature
  1. Schreckenbach T, Zeller MV, El Youzouri H, et al. Identification of factors predictive of postoperative morbidity and short-term mortality in older patients after colorectal carcinoma resection: a single-center retrospective study[J]. J Geriatr Oncol. 2018;9:649–58.View ArticlePubMed
  2. Simon K. Colorectal cancer development and advances in screening[J]. Clin Interv Aging. 2016;11:967–76.View ArticlePubMedPubMed Central
  3. Guo H, Zhou X, Lu Y, et al. Translational progress on tumor biomarkers[J]. Thorac Cancer. 2015;6(6):665–71.View ArticlePubMedPubMed Central
  4. Mouchli MA, Ouk L, Scheitel MR, et al. Colonoscopy surveillance for high risk polyps does not always prevent colorectal cancer[J]. World J Gastroenterol. 2018;24(8):905–16.View ArticlePubMedPubMed Central
  5. Iwamoto M, Kawada K, Hida K, et al. Delayed anastomotic leakage following laparoscopic intersphincteric resection for lower rectal cancer: report of four cases and literature review[J]. World J Surg Oncol. 2017;15(1):143.View ArticlePubMedPubMed Central
  6. Zając O, Spychała A, Murawa D, et al. Quality of life assessment in patients with a stoma due to rectal cancer[J]. Rep Pract Oncol Radiother. 2008;13(3):130–4.View Article
  7. Elfeki H, Thyo A, Nepogodiev D, et al. Patient and healthcare professional perceptions of colostomy-related problems and their impact on quality of life following rectal cancer surgery[J]. BJS Open. 2018;2(5):336–44.View ArticlePubMedPubMed Central
  8. Jo S, Choi Y, Park SK, et al. Efficacy of dose-escalated radiotherapy for recurrent colorectal cancer[J]. Ann Coloproctol. 2016;32(2):66–72.View ArticlePubMedPubMed Central
  9. Methy N, Bedenne L, Bonnetain F. Surrogate endpoints for overall survival in digestive oncology trials: which candidates? A questionnaires survey among clinicians and methodologists[J]. BMC Cancer. 2010;10:277.View ArticlePubMedPubMed Central
  10. Du P, Xu B, Zhang D, et al. Hierarchical investigating the predictive value of p53, COX2, EGFR, nm23 in the post-operative patients with colorectal carcinoma[J]. Oncotarget. 2017;8(1):954–66.View ArticlePubMed
  11. Kim JW. The quality of life after rectal cancer surgery[J]. Korean J Gastroenterol. 2006;47(4):295–9.PubMed
  12. Souza J, Nahas CSR, Nahas SC, et al. Health-related quality of life assessment in patients with rectal cancer treated with curative intent[J]. Arq Gastroenterol. 2018;55(2):154–9.View ArticlePubMed
  13. Aaronson NK, Ahmedzai S, Bergman B, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology[J]. J Natl Cancer Inst. 1993;85(5):365–76.View Article
  14. Sprangers MA, te Velde A, Aaronson NK. The construction and testing of the EORTC colorectal cancer-specific quality of life questionnaire module (QLQ-CR14). European Organization for Research and Treatment of Cancer Study Group on Quality of Life[J]. Eur J Cancer. 1999;35(2):238–47.View ArticlePubMed
  15. Lin JK, Tan EC, Yang MC. Comparing the effectiveness of capecitabine versus 5-fluorouracil/leucovorin therapy for elderly Taiwanese stage III colorectal cancer patients based on quality-of-life measures (QLQ-C30 and QLQ-CR1) and a new cost assessment tool[J]. Health Qual Life Outcomes. 2015;13:61.View ArticlePubMedPubMed Central
  16. World Medical A. World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects[J]. Bull World Health Organ. 2001;79(4):373–4.
  17. Kopp I, Bauhofer A, Koller M. Understanding quality of life in patients with colorectal cancer: comparison of data from a randomised controlled trial, a population based cohort study and the norm reference population[J]. Inflamm Res. 2004;53(Suppl 2):S130–5.PubMed
  18. The World Cancer. Report—the major findings[J]. Cent. Eur J Public Health. 2003;11(3):177–9.
  19. Reinwalds M, Blixter A, Carlsson E. A descriptive, qualitative study to assess patient experiences following stoma reversal after rectal cancer surgery[J]. Ostomy Wound Manag. 2017;63(12):29–37.
  20. Nasvall P, Dahlstrand U, Lowenmark T, et al. Quality of life in patients with a permanent stoma after rectal cancer surgery[J]. Qual Life Res. 2017;26(1):55–64.View ArticlePubMed
  21. Herrle F, Sandra-Petrescu F, Weiss C, et al. Quality of life and timing of stoma closure in patients with rectal cancer undergoing low anterior resection with diverting stoma: a multicenter longitudinal observational study[J]. Dis Colon Rectum. 2016;59(4):281–90.View ArticlePubMed
  22. Segalla JG, Van Eyll B, Federico MH, et al. Evaluation of quality of life in patients with metastatic colorectal cancer treated with capecitabine[J]. Clin Colorectal Cancer. 2008;7(2):126–33.View ArticlePubMed
  23. Pachler J, Wille-Jorgensen P. Quality of life after rectal resection for cancer, with or without permanent colostomy[J]. Cochrane Database Syst Rev. 2012;12:CD004323.PubMed
  24. Neuman HB, Park J, Fuzesi S, et al. Rectal cancer patients’ quality of life with a temporary stoma: shifting perspectives[J]. Dis Colon Rectum. 2012;55(11):1117–24.View ArticlePubMed
  25. Cakmak A, Aylaz G, Kuzu MA. Permanent stoma not only affects patients’ quality of life but also that of their spouses[J]. World J Surg. 2010;34(12):2872–6.View ArticlePubMed
  26. Sideris L, Zenasni F, Vernerey D, et al. Quality of life of patients operated on for low rectal cancer: impact of the type of surgery and patients’ characteristics[J]. Dis Colon Rectum. 2005;48(12):2180–91.View ArticlePubMed
Metadata
Title
Comparison of overall survival and quality of life between patients undergoing anal reconstruction and patients undergoing traditional lower abdominal stoma after radical resection
Authors
P. Du
S.-Y. Wang
P.-F. Zheng
J. Mao
H. Hu
Z.-B. Cheng
Publication date
01-10-2019
Publisher
Springer International Publishing
Published in
Clinical and Translational Oncology / Issue 10/2019
Print ISSN: 1699-048X
Electronic ISSN: 1699-3055
DOI
https://doi.org/10.1007/s12094-019-02106-x

Other articles of this Issue 10/2019

Clinical and Translational Oncology 10/2019 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine