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 14 December 2017

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News

Quality of life in rectal cancer patients after chemoradiation

The latest issue of the Diseases of the Colon & Rectum investigates whether a watch-and-wait policy improves quality of life and functional outcome in rectal cancer.

News image

Fifteen to twenty percent of patients with locally advanced rectal cancer have a clinical complete response after chemoradiation therapy.

These patients can be offered nonoperative organ-preserving treatment, the so-called watch-and-wait policy.

Dr Britt Hupkens and colleagues examined whether this watch-and-wait policy is an anticipated improved quality of life and functional outcome in comparison with a total mesorectal excision, while maintaining a good oncological outcome.

The researchers compared the quality of life of watch-and-wait patients with a matched-controlled group of patients who underwent chemoradiation and surgery.

The team performed a matched controlled study conducted at multiple centers.

The study population consisted of 2 groups: 41 patients after a watch-and-wait policy and 41 matched patients after chemoradiation and surgery.

The watch-and-wait group had better physical and cognitive function
Diseases of the Colon & Rectum

Patients were matched on sex, age, tumor stage, and tumor height.

All patients were disease free at the moment of recruitment after a minimal follow-up of 2 years.

The team measured quality of life by validated questionnaires covering general quality of life, disease-specific total mesorectal excision, defecation problems, sexual problems, and urinary dysfunction.

The researchers showed that the watch-and-wait group had better physical and cognitive function, better physical and emotional roles, and better global health status compared with the total mesorectal excision group. The watch-and-wait patients showed fewer problems with defecation and sexual and urinary tract function.

Dr Hupkens' team comments, "After a successful watch-and-wait approach, the quality of life was better than after chemoradiation and surgery on several domains."

"However, chemoradiation therapy on its own is not without long-term side effects, because one-third of the watch-and-wait patients experienced major low anterior resection syndrome symptoms, compared with 67% of the patients in the total mesorectal excision group."

Dis Colon Rectum 2017: 60(10): 1032–1040
05 October 2017

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