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- Title
Quality of life in non-early rectal cancer treated by neoadjuvant radio-chemotherapy and endoluminal loco-regional resection (ELRR) by transanal endoscopic microsurgery (TEM) versus laparoscopic total mesorectal excision.
- Authors
D'Ambrosio, Giancarlo; Paganini, Alessandro; Balla, Andrea; Quaresima, Silvia; Ursi, Pietro; Bruzzone, Paolo; Picchetto, Andrea; Mattei, Fabrizio; Lezoche, Emanuele; Paganini, Alessandro M; Mattei, Fabrizio I
- Abstract
<bold>Background: </bold>In selected patients with N0 rectal cancer, endoluminal loco-regional resection (ELRR) by transanal endoscopic microsurgery (TEM) may be an alternative treatment option to laparoscopic total mesorectal excision (LTME). Aim of this study is to evaluate the short- and medium-term quality of life (QoL) from a retrospective analysis of prospectively collected data in patients with iT2-iT3 N0-N+ rectal cancer, who underwent ELRR by TEM or LTME after neoadjuvant radio-chemotherapy (n-RCT).<bold>Methods: </bold>Thirty patients with iT2-iT3 rectal cancer who underwent ELRR by TEM (n = 15) or LTME (n = 15) were enrolled in this study. The choice for one operation or the other was made on the basis of predefined criteria. QoL was evaluated by EORTC QLQ-C30 and QLQ-CR38 questionnaires at admission, after n-RCT and 1, 6, and 12 months after surgery.<bold>Results: </bold>No statistically significant differences in QoL evaluation were observed between the two groups, both at admission and after n-RCT. At 1 month after surgery, significantly better results in the ELRR group were observed by QLQ-C30 in: Nausea/Vomiting (p = 0.05), Appetite Loss (p = 0.003), Constipation (p = 0.05), and by QLQ-CR38 in: Body Image (p = 0.05), Sexual Functioning (p = 0.03), Future Perspective (p = 0.05) and Weight Loss (p = 0.036). At 6 months after surgery, a statistically significant worse impact after LTME was observed by QLQ-C30 in: Global Health Status (p = 0.05), Emotional Functioning (p = 0.021), Dyspnea (p = 0.008), Insomnia (p = 0.012), Appetite Loss (p = 0.014) and by QLQ-CR38 in Body Image (p = 0.05) and Defecation Problems (p = 0.001). At 1 year, the two groups were homogenous as assessed by QLQ-C30, whereas the QLQ-CR38 still showed better results of ELRR versus LTME in Body Image (p = 0.006), Defecation Problems (p = 0.01), and Weight Loss (p = 0.005).<bold>Conclusions: </bold>Based on the present series, in selected patients, earlier restoration of patients' functions is observed after ELRR by TEM than after LTME.
- Subjects
QUALITY of life; RECTAL cancer; ENDOSCOPIC surgery; MICROSURGERY; CONSTIPATION; RECTAL surgery; COMBINED modality therapy; COMPARATIVE studies; LAPAROSCOPY; RESEARCH methodology; MEDICAL cooperation; QUESTIONNAIRES; RECTUM tumors; RESEARCH; TUMOR classification; EVALUATION research; TREATMENT effectiveness; RETROSPECTIVE studies; TUMOR treatment
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2016, Vol 30, Issue 2, p504
- ISSN
1866-6817
- Publication type
journal article
- DOI
10.1007/s00464-015-4232-8