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10.1245/s10434-007-9748-2
Annals of Surgical Oncology 15:1099-1106 (2008)
© 2008 Society of Surgical Oncology
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Original Article

Quality of Life Among Five-Year Survivors After Treatment for Very Low Rectal Cancer With or Without a Permanent Abdominal Stoma

C. Fucini, MD, R. Gattai, MD, C. Urena, MD, L. Bandettini, MD and C. Elbetti, MD

Department of Medical and Surgical Critical Care, Section of General and Oncological Surgery, University of Florence, Viale Morgagni, 85, 50134, Firenze, Italy

Correspondence: Address correspondence and reprint requests to: C. Fucini, MD; E-mail: claudio.fucini{at}unifi.it

Background: Low rectal cancers situated less than 5 cm from the anal margin are still usually treated with abdominoperineal excision (APE). Our aim is to compare the quality of life (QOL) of five-year survivors treated for low or very low rectal cancer with an advanced/complex coloanal procedure with the QOL of patients submitted to a standard APE with a definitive abdominal stoma.

Methods: Sixty-two patients, operated on radically for low or very low rectal cancer, who came for their fifth year follow-up visit and were free from cancer, were studied. Thirty patients (group 1) had an APE with permanent abdominal stoma. Thirty-two patients (group 2) had undergone a radical advanced and complex procedure to avoid the abdominal stoma. The patients received the European Organisation for the Research and Treatment of Cancer (EORTC) QOL-30 generic and the CR38 colorectal cancer QOL questionnaires with the recommendation to return the questionnaire to the hospital. The Mann–Whitney U-test and {chi}2 Fisher test were employed for statistical analysis.

Results: All questionnaires were returned. Patients without a terminal abdominal stoma had a better score in six categories of the QOL 30 and in two categories of the CR38. No differences were observed in the other variables examined.

Conclusions: After five years, cancer-free patients operated on for low or very low rectal cancer have a better QOL if a definitive terminal abdominal stoma was avoided.

Key Words: Rectal cancer • Coloanal anastomosis • Quality of life






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