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International Journal of Colorectal Disease

, Volume 34, Issue 4, pp 747–762 | Cite as

To what extent is the low anterior resection syndrome (LARS) associated with quality of life as measured using the EORTC C30 and CR38 quality of life questionnaires?

  • Juliane Kupsch
  • Matthias Kuhn
  • Klaus E. Matzel
  • Joerg Zimmer
  • Olga Radulova-Mauersberger
  • Anja Sims
  • Helmut Witzigmann
  • Sigmar StelznerEmail author
Original Article

Abstract

Purpose

Treatment of rectal cancer often results in disturbed anorectal function, which can be quantified by the Low Anterior Resection Syndrome (LARS) score. This study investigates the association of impaired anorectal function as measured with the LARS score with quality of life (QoL) as measured with the EORTC-QLQ-C30 and CR38 questionnaires.

Methods

All stoma-free patients who had undergone sphincter-preserving surgery for rectal cancer from 2000 to 2014 in our institution were retrieved from a prospective database. They were contacted by mail and asked to return the questionnaires. QoL was evaluated in relation to LARS and further patient- and treatment factors using univariate and multivariate analysis.

Results

Of the eligible patients (n = 331), 261 (78.8%) responded with a complete LARS score. Mean score for global QoL according to the EORTC-QLQ-C30 questionnaire was 63 ± 21 for all patients. If major LARS was present, mean score decreased to 56 ± 19 in contrast to 67 ± 20 in patients with no/minor LARS (p < 0.001). In regression analysis, major LARS was furthermore associated with reduced physical, role, emotional, cognitive and social functioning as well as impaired body image, more micturition problems and poorer future perspective. It was not related to sexual function. The variance explained by major LARS in the differences of QoL was approximately 10%.

Conclusion

The presence of major LARS after rectal resection for cancer is negatively associated with global health as well as many other aspects of QoL. Preserving anorectal function and treatment of LARS are potential measures to improve QoL in this patient group.

Keywords

Rectal cancer Sphincter-preserving surgery Quality of life Low anterior resection syndrome score 

Notes

Acknowledgments

The authors are indebted to Lisa Domichowski, Medical Data Manager, for her support in data acquisition. The maintenance of the database at the Coloproctologic Unit of Dresden-Friedrichstadt General Hospital is supported by a grant from the Tumour Centre Dresden.

Compliance with ethical standards

Ethical approval was granted by the responsible institution (Saxon Physicians Chamber, No. EK-BR-92/15-1/134619).

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of General, Visceral and Thoracic Surgery, Dresden-Friedrichstadt General HospitalTeaching Hospital of the Technical University of DresdenDresdenGermany
  2. 2.Institute for Medical Informatics and Biometry, (Carl Gustav Carus) Faculty of MedicineTechnische Universität DresdenDresdenGermany
  3. 3.Department of Surgery, Section Coloproctology, University Hospital ErlangenFriedrich-Alexander University Erlangen-NürnbergErlangenGermany
  4. 4.Department of Radiation Therapy, Dresden-Friedrichstadt General HospitalTeaching Hospital of the Technical University of DresdenDresdenGermany

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