Abstract
Background and Aims:Low anterior resection syndrome is common after anterior resection for rectal cancer. Its severity can be tested with the low anterior resection syndrome score. We have translated the low anterior resection syndrome score to Finnish, and the aim of this study is to validate the translation.Materials and Methods:The translated Finnish low anterior resection syndrome score and European Organisation for Research and Treatment of Cancer quality-of-life questionnaire-C30 and QLQ-CR29 questionnaires were sent to 159 surviving patients operated with anterior resection for rectal adenocarcinoma between 2007 and 2014 in a tertiary referral center. Psychometric properties of the translation were evaluated in comparison to quality-of-life scales and in different risk factor groups.Results:In the study, 104 (65%) patients returned the questionnaires. Of these, 56 (54%) had major low anterior resection syndrome, 26 (25%) had minor low anterior resection syndrome, and 22 (21%) had no low anterior resection syndrome. Patients with major low anterior resection syndrome had a significantly lower quality of life and more defecatory symptoms as assessed with the European Organisation for Research and Treatment of Cancer questionnaires compared with those with no low anterior resection syndrome. Patients operated with total mesorectal excision had significantly higher low anterior resection syndrome scores compared with those operated with partial mesorectal excision (median/interquartile range 32/15 and 29/11, respectively, p = 0.037). The test–retest validity of the translation was good with an intraclass correlation coefficient of 0.77 (95% confidence interval 0.51–0.90).Conclusions:The Finnish low anterior resection syndrome score is a valid test in the assessment of postoperative bowel function and its impact on the quality of life. It can be implemented to use during regular follow-up visits of Finnish-speaking rectal cancer patients.
Highlights
Defecation disorders are frequent after anterior resection for rectal cancer
Forward and backward translations were performed by colorectal surgeons, linguists, and native English speakers according to published protocols for translating health status questionnaires[22, 23]
Convergent validity of the translation was tested by comparing the results of the Finnish low anterior resection syndrome (LARS) score with the results of previously validated Finnish versions of EORTC QLQs
Summary
Defecation disorders are frequent after anterior resection for rectal cancer. The usual combination of symptoms (urgency, fragmentation, incontinence) is called low anterior resection syndrome (LARS) and was described already in the 1990s1. To ease the assessment of the severity of defecatory symptoms, the LARS score was developed by Emmertsen and Laurberg[13]. It is a five-item questionnaire, by which patients can be divided into having no, minor, or major LARS. This division correlates with the amount of impact that bowel function disorders have on the quality of life of the patient. LARS score has been widely adopted by the clinical and research communities and has been translated and validated in many languages[14,15,16,17,18,19,20]. The purpose of this study is to validate the Finnish version of the LARS score, so that it can be adopted for clinical use in Finland
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