Background:
Aim:
: To evaluate the effect of neoadjuvant chemoradiation followed by sphincter preserving surgery on anorectal function and its correlation with quality of life in rectal cancer patients.
:
Methods:
: Twenty-six rectal cancer patients were evaluated in this analysis. All patients had preoperative chemoradiotherapy and low anterior resection thereafter. Median radiotherapy dose was 50.4 Gy (range, 45 to 54 Gy) and patients received concurrent fluorouracil-based chemotherapy (400 mg/m2/IV/bolus). Fecal incontinence questionnaire (Wexner score), anorectal manometry test (AMT) and quality of life questionnaire (EORTC C30 and CR38) were done to all patients. Mean anal resting pressure (MRP), mean anal squeeze pressure (MSP) and, recto anal inhibitory reflex volume (RAIR) and rectal sensory threshold (RST) were measured by anal manometer. Correlation between parameters of Wexner scores, quality of life scales, manometric scores and complaints (urgency or soiling) of patients were assessed with Pearson test. P<0.05 were considered statistically significant.
Results:
: Median follow-up was 47 months (range, 8 to 98 months). Urgency or soiling and anorectal function results were correlated with Wexner scores. In quality of life scales, body image (p=0.03), future perspective (p=0.02), sexual functioning (p=0.001) and defecation problems (p=0.003) were correlated with urgency; physical functioning (p=0.02) was correlated with soiling in patients.
Conclusions:
Neoadjuvant chemoradiation may impair overall long-term sphincter function significantly. This effect reflects to patients` quality of life in during follow-up. Therefore, patients’ selection should be done carefully in terms of sphincter preserving surgery.