Aims
While the influence on survival is only seen in patients with complete regression after neoadjuvant treatment in locally advanced rectal cancer the impairment of the continence capacity weighs even more for patients with little oncological benefit.
Methods
Patients treated with intensified preoperative radiochemotherapy patients treated only by TME surgery were asked five years after treatment to complete the Wexner and SF-12 quality of life questionnaire.
Results
25 after neoadjuvant treatment had a median Wexner score of 14 [3-20] after 63 [42-78] months. Histopathological stage or grade of regression did not influence the Wexner score (p聽=聽0.76, resp. p聽=聽0.9). 12% describe themselves as being permanently continent; 40% are stool incontinent 鈥渁lways鈥?or 鈥渕ost of the time鈥? 68% are always wearing pads.
29 patients after TME only showed a median Wexner score of 5 [range 0-17] after 66 months [26-133].
SF-12 showed significantly lower values in physical (p聽=聽0.02) as well as mental summary scales (p聽=聽0.015) in patients after RCTX while patients after radical surgery showed no difference to the norm population.
Conclusion
This study shows that continence is significantly worse five years after neoadjuvant treatment. Moreover, patients after neoadjuvant treatment and surgery have impaired quality of life compared to norm population. These results may contribute to the discussion of only applying neoadjuvant chemoradiation selectively in patients with advanced rectal cancer.
