Does extended surgery influence health-related quality of life in patients with rectal cancer?

R. Orsini, T.A. Vermeer, M.J. Traa, G.A.P. Nieuwenhuijzen, I.H.J.T. de Hingh, H.J. Rutten

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Background: 
In locally advanced rectal cancer, an extended resection peripheral to the mesorectal fascia is needed to achieve a radical resection. The influence of extended resections on health-related quality of life is unclear.
Objective: Differences in health-related quality of life and sexuality between patients receiving standard surgery and patients receiving extended surgery were examined, with a focus on age.
Design: 
Patients operated on for rectal cancer between 2000 and 2010 were selected from a database and invited to complete the European Organization for Research and Treatment of Cancer quality-of-life questionnaires (C30 and ColoRectal 38).
Settings: 
All patients were treated at the Catharina Hospital, Eindhoven, the Netherlands.
Patients: 
All patients received total mesorectal excision surgery or extended surgery for rectal cancer.
Main outcome measures: Health-related quality of life and sexual activity was compared between patients treated with total mesorectal excision surgery and extended surgery and further stratified by age at the time of surgery (<70 and ≥70).RESULTS: Two hundred twenty-nine (64.1%) patients with standard surgery and 128 (35.9%) patients treated with extended resections responded. Extended surgery in patients <70 years resulted in lower body image compared with patients <70 years receiving standard surgery. Patients ≥70 years had lower sexual function and more male sexual dysfunction than patients <70 years undergoing standard surgery. In all groups, sexual activity dropped significantly after treatment.LIMITATIONS: No information was available of the patients' health-related quality of life before treatment except for the retrospective question about sexual activity.
Conclusions: 
This study showed no major differences between patients undergoing total mesorectal excision surgery and those receiving extended surgery, with the exception of body image, which was significantly lower in patients <70 years undergoing extended surgery. In all patient groups, treatment for rectal cancer influenced sexual activity dramatically. Awareness of the impact of surgery on health-related quality of life and sexuality is needed.
Original languageEnglish
Pages (from-to)179-185
JournalDiseases of the Colon & Rectum
Volume58
Issue number2
DOIs
Publication statusPublished - 2015

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Orsini, R., Vermeer, T. A., Traa, M. J., Nieuwenhuijzen, G. A. P., de Hingh, I. H. J. T., & Rutten, H. J. (2015). Does extended surgery influence health-related quality of life in patients with rectal cancer? Diseases of the Colon & Rectum, 58(2), 179-185. https://doi.org/10.1097/DCR.0000000000000292
Orsini, R. ; Vermeer, T.A. ; Traa, M.J. ; Nieuwenhuijzen, G.A.P. ; de Hingh, I.H.J.T. ; Rutten, H.J. / Does extended surgery influence health-related quality of life in patients with rectal cancer?. In: Diseases of the Colon & Rectum. 2015 ; Vol. 58, No. 2. pp. 179-185.
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title = "Does extended surgery influence health-related quality of life in patients with rectal cancer?",
abstract = "Background: In locally advanced rectal cancer, an extended resection peripheral to the mesorectal fascia is needed to achieve a radical resection. The influence of extended resections on health-related quality of life is unclear.Objective: Differences in health-related quality of life and sexuality between patients receiving standard surgery and patients receiving extended surgery were examined, with a focus on age.Design: Patients operated on for rectal cancer between 2000 and 2010 were selected from a database and invited to complete the European Organization for Research and Treatment of Cancer quality-of-life questionnaires (C30 and ColoRectal 38).Settings: All patients were treated at the Catharina Hospital, Eindhoven, the Netherlands.Patients: All patients received total mesorectal excision surgery or extended surgery for rectal cancer.Main outcome measures: Health-related quality of life and sexual activity was compared between patients treated with total mesorectal excision surgery and extended surgery and further stratified by age at the time of surgery (<70 and ≥70).RESULTS: Two hundred twenty-nine (64.1{\%}) patients with standard surgery and 128 (35.9{\%}) patients treated with extended resections responded. Extended surgery in patients <70 years resulted in lower body image compared with patients <70 years receiving standard surgery. Patients ≥70 years had lower sexual function and more male sexual dysfunction than patients <70 years undergoing standard surgery. In all groups, sexual activity dropped significantly after treatment.LIMITATIONS: No information was available of the patients' health-related quality of life before treatment except for the retrospective question about sexual activity.Conclusions: This study showed no major differences between patients undergoing total mesorectal excision surgery and those receiving extended surgery, with the exception of body image, which was significantly lower in patients <70 years undergoing extended surgery. In all patient groups, treatment for rectal cancer influenced sexual activity dramatically. Awareness of the impact of surgery on health-related quality of life and sexuality is needed.",
author = "R. Orsini and T.A. Vermeer and M.J. Traa and G.A.P. Nieuwenhuijzen and {de Hingh}, I.H.J.T. and H.J. Rutten",
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Orsini, R, Vermeer, TA, Traa, MJ, Nieuwenhuijzen, GAP, de Hingh, IHJT & Rutten, HJ 2015, 'Does extended surgery influence health-related quality of life in patients with rectal cancer?', Diseases of the Colon & Rectum, vol. 58, no. 2, pp. 179-185. https://doi.org/10.1097/DCR.0000000000000292

Does extended surgery influence health-related quality of life in patients with rectal cancer? / Orsini, R.; Vermeer, T.A.; Traa, M.J.; Nieuwenhuijzen, G.A.P.; de Hingh, I.H.J.T.; Rutten, H.J.

In: Diseases of the Colon & Rectum, Vol. 58, No. 2, 2015, p. 179-185.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Does extended surgery influence health-related quality of life in patients with rectal cancer?

AU - Orsini, R.

AU - Vermeer, T.A.

AU - Traa, M.J.

AU - Nieuwenhuijzen, G.A.P.

AU - de Hingh, I.H.J.T.

AU - Rutten, H.J.

PY - 2015

Y1 - 2015

N2 - Background: In locally advanced rectal cancer, an extended resection peripheral to the mesorectal fascia is needed to achieve a radical resection. The influence of extended resections on health-related quality of life is unclear.Objective: Differences in health-related quality of life and sexuality between patients receiving standard surgery and patients receiving extended surgery were examined, with a focus on age.Design: Patients operated on for rectal cancer between 2000 and 2010 were selected from a database and invited to complete the European Organization for Research and Treatment of Cancer quality-of-life questionnaires (C30 and ColoRectal 38).Settings: All patients were treated at the Catharina Hospital, Eindhoven, the Netherlands.Patients: All patients received total mesorectal excision surgery or extended surgery for rectal cancer.Main outcome measures: Health-related quality of life and sexual activity was compared between patients treated with total mesorectal excision surgery and extended surgery and further stratified by age at the time of surgery (<70 and ≥70).RESULTS: Two hundred twenty-nine (64.1%) patients with standard surgery and 128 (35.9%) patients treated with extended resections responded. Extended surgery in patients <70 years resulted in lower body image compared with patients <70 years receiving standard surgery. Patients ≥70 years had lower sexual function and more male sexual dysfunction than patients <70 years undergoing standard surgery. In all groups, sexual activity dropped significantly after treatment.LIMITATIONS: No information was available of the patients' health-related quality of life before treatment except for the retrospective question about sexual activity.Conclusions: This study showed no major differences between patients undergoing total mesorectal excision surgery and those receiving extended surgery, with the exception of body image, which was significantly lower in patients <70 years undergoing extended surgery. In all patient groups, treatment for rectal cancer influenced sexual activity dramatically. Awareness of the impact of surgery on health-related quality of life and sexuality is needed.

AB - Background: In locally advanced rectal cancer, an extended resection peripheral to the mesorectal fascia is needed to achieve a radical resection. The influence of extended resections on health-related quality of life is unclear.Objective: Differences in health-related quality of life and sexuality between patients receiving standard surgery and patients receiving extended surgery were examined, with a focus on age.Design: Patients operated on for rectal cancer between 2000 and 2010 were selected from a database and invited to complete the European Organization for Research and Treatment of Cancer quality-of-life questionnaires (C30 and ColoRectal 38).Settings: All patients were treated at the Catharina Hospital, Eindhoven, the Netherlands.Patients: All patients received total mesorectal excision surgery or extended surgery for rectal cancer.Main outcome measures: Health-related quality of life and sexual activity was compared between patients treated with total mesorectal excision surgery and extended surgery and further stratified by age at the time of surgery (<70 and ≥70).RESULTS: Two hundred twenty-nine (64.1%) patients with standard surgery and 128 (35.9%) patients treated with extended resections responded. Extended surgery in patients <70 years resulted in lower body image compared with patients <70 years receiving standard surgery. Patients ≥70 years had lower sexual function and more male sexual dysfunction than patients <70 years undergoing standard surgery. In all groups, sexual activity dropped significantly after treatment.LIMITATIONS: No information was available of the patients' health-related quality of life before treatment except for the retrospective question about sexual activity.Conclusions: This study showed no major differences between patients undergoing total mesorectal excision surgery and those receiving extended surgery, with the exception of body image, which was significantly lower in patients <70 years undergoing extended surgery. In all patient groups, treatment for rectal cancer influenced sexual activity dramatically. Awareness of the impact of surgery on health-related quality of life and sexuality is needed.

U2 - 10.1097/DCR.0000000000000292

DO - 10.1097/DCR.0000000000000292

M3 - Article

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EP - 185

JO - Diseases of the Colon & Rectum

JF - Diseases of the Colon & Rectum

SN - 0012-3706

IS - 2

ER -