Quality of life outcomes in patients undergoing surgery for locally recurrent rectal cancer

Abstract

BackgroundSurvival has been considered the key outcome measure for cancer patients, however quality of life (QoL) is increasingly being considered as an important outcome measure. MethodThe Cochrane Central Register of Controlled Trials, MEDLINE, Embase and CINAHL were searched using medical subject headings. Reference lists of identified studies, clinicaltrials.gov and the WHO International Clinical Trials Registry were also searched. All clinical trials which included recurrent rectal cancer and QoL were identified, with restrictions to human, since 2000 and English language. Results16 publications were identified. The studies were quite heterogeneous with regard to the patients included, tools used to assess QoL, times when QoL is assessed and comparator groups; they were further limited by small sample size. Many studies reported combined data with local advanced rectal cancer. ConclusionPatients with recurrent rectal cancer have impaired QoL. Surgery further impairs their QoL, for between 6 and 9 months. The dimensions affected include urinary, and sexual function, feceal incontinence, pelvic pain, muscular skeletal function, and employment. Predictors of poor post operative QoL are poor preoperative Qol, female, and need for a boney resection. Patients who receive an R0 resection have better QoL than those after a R1 or R2 resection.