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Health-related quality of life (HRQoL) assessment is important in understanding the patient’s perspective and for decision-making in health care. HRQoL is often impaired in patients with stoma. The aim was to evaluate HRQoL in rectal cancer patients with permanent stoma compared to patients without stoma.
711 patients operated for rectal cancer with abdomino-perineal resection or Hartman’s procedure and a control group (n = 275) operated with anterior resection were eligible. Four QoL questionnaires were sent by mail. Comparisons of mean values between groups were made by Student´s independent t test. Comparison was made to a Swedish background population.
336 patients with a stoma and 117 without stoma replied (453/986; 46 %). A bulging or a hernia around the stoma was present in 31.5 %. Operation due to parastomal hernia had been performed in 11.7 % in the stoma group. Mental health (p = 0.007), body image (p < 0.001), and physical (p = 0.016) and emotional function (p = 0.003) were inferior in patients with stoma. Fatigue (p = 0.019) and loss of appetite (p = 0.027) were also more prominent in the stoma group. Sexual function was impaired in the non-stoma group (p = 0.034). However in the stoma group, patients with a bulge/hernia had more sexual problems (p = 0.004). Pain was associated with bulge/hernia (p < 0.001) and fear for leakage decreased QoL (p < 0.001). HRQoL was impaired compared to the Swedish background population.
Overall HRQoL in patients operated for rectal cancer with permanent stoma was inferior compared to patients without stoma. In the stoma group, a bulge or a hernia around the stoma further impaired HRQoL.
Pahlman, L., & Glimelius, B. (1984). Local recurrences after surgical treatment for rectal carcinoma. Acta Chirurgica Scandinavica, 150(4), 331–335. PubMed
Pachler, J., & Wille-Jorgensen, P. (2012). Quality of life after rectal resection for cancer, with or without permanent colostomy. The Cochrane Database of Systematic Reviews, 12, CD004323. PubMed
Aaronson, N. K., Ahmedzai, S., Bergman, B., Bullinger, M., Cull, A., Duez, N. J., et al. (1993). The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. Journal of the National Cancer Institute, 85(5), 365–376. CrossRefPubMed
Sprangers, M. A., te Velde, A., & Aaronson, N. K. (1999). The construction and testing of the EORTC colorectal cancer-specific quality of life questionnaire module (QLQ-CR38). European Organization for Research and Treatment of Cancer Study Group on Quality of Life. European Journal of Cancer, 35(2), 238–247. CrossRefPubMed
Fayers, P. M., Aaronason, N. K., Bjorda, L. K., Groenvold, M., Curran, D., & Bottomley, A. (2001). on behalf of the EORTC Quality of Life Group. The EORTC QLQ-C30 Scoring Manual (3rd ed.). Brussels: European Organisation for Research and Treatment of Cancer.
Wong, C. K., Chen, J., Yu, C. L., Sham, M., & Lam, C. L. (2015). Systematic review recommends the European Organization for Research and Treatment of Cancer colorectal cancer-specific module for measuring quality of life in colorectal cancer patients. Journal of Clinical Epidemiology, 68(3), 266–278. CrossRefPubMed
Digennaro, R., Tondo, M., Cuccia, F., Giannini, I., Pezzolla, F., Rinaldi, M., et al. (2013). Coloanal anastomosis or abdominoperineal resection for very low rectal cancer: What will benefit, the surgeon’s pride or the patient’s quality of life? International Journal of Colorectal Disease, 28(7), 949–957. CrossRefPubMed
- Quality of life in patients with a permanent stoma after rectal cancer surgery
- Springer International Publishing