Abstract
BackgroundUp to 80% of patients with rectal cancer undergo sphincter-saving surgery, and almost 90% of them experience subsequent physical changes. The number of studies on gender differences in response to this surgery has increased, and the connection between gender and symptoms and patient outcomes has generated increasing interest. Nevertheless, little is known about the gender differences in quality of life and cancer-related symptoms. We examined gender differences and quality of life changes over a 1-year period among patients with lower rectal cancer who were treated with sphincter-saving surgery.MethodsPatients (men = 42; women = 33) completed a self-administered questionnaire on their quality of life and related factors before surgery and 1, 6, and 12 months afterwards. The questionnaire was developed by the European Organization for Research and Treatment of Cancer (EORTC QLQ-C30/CR-38).ResultsScores on physical, role, and social functioning and global health status/quality of life decreased 1 month after surgery, improved after 6 months, and returned to baseline within 12 months, with the exception of social functioning in men. Factors related to quality of life changed after surgery and differed between men and women. Women’s global health status/quality of life was affected by fatigue, weight loss, defecation problems, and future perspective, while that of men was affected by fatigue, weight loss, future perspective, and role functioning, which was affected by pain, defecation problems, and financial difficulties.ConclusionsGender differences should be considered when predicting the quality of life of cancer patients undergoing surgery. Identifying gender differences will help health care providers anticipate the unique needs of patients undergoing surgery for rectal cancer.
Highlights
The patients’ scores on global health status/quality of life (QOL) and social functioning were more than ten points lower than the reference data
We found a small decrease in global health status/QOL 1 month after surgery and an improvement after 6 months
The present results suggest that gender is an important consideration in explaining the QOL between individuals
Summary
Up to 80% of patients with rectal cancer undergo sphincter-saving surgery, and almost 90% of them experience subsequent physical changes. We examined gender differences and quality of life changes over a 1-year period among patients with lower rectal cancer who were treated with sphincter-saving surgery. Due to the decreased quality of life (QOL) that accompanies APR with a permanent stoma, it tends to be avoided, and low anterior resection (LAR) is chosen instead [1]. Traa et al reported that treatment groups of 439 patients with rectal cancer had lower QOL and sexual functioning compared to the general population [2]. That study reported that rectal cancer patients having SSS might experience symptoms affecting their QOL that are different from those of stoma patients. The study’s conclusions did not appear in a meta-analysis conducted by Cornish et al or in a systematic review by Pachler and Wille-Jørgensen published in the Cochrane Database [4,5]
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