Quality of life in patients after combined modality treatment of rectal cancer: Report of a prospective phase II study

Background. The literature reports are unclear whether a permanent stoma reduces the quality of life (QOL) of patients with locally advanced rectal cancer (T3-4 and/or N+). Our aim was to compare the QLQ of patients with abdominoperineal resection and with restorative surgery, treated with preoperative radiochemotherapy in a prospective phase II clinical trial. Methods. Fifty-seven patients were irradiated to 45 Gy in 25 fractions over 5 weeks to the pelvis concomitantly with oral capecitabine 825 mg/m2, twice a day, including weekends. Surgery was scheduled 4-6 weeks after the completion of the chemoradiotherapy. Four courses of chemotherapy were planned postoperatively. Patients still alive and without recurrence of the disease, with a minimum follow up of 2 years, were surveyed with two self-rating questionnaires developed by the European Organisation for Research and Treatment of Cancer (EORTC): one was cancer specific (EORTC QLQ-C30) and one was site specific (EORTC QLQ-C38). Results. QLQ was assessed in 28 of 32 patients eligible (87.5%). The median time from surgery to filling in the questionnaires was 35 months. For all scales of EORTC QLQ-C30 and EORTC QLQ-C38, no significant differences in median scores were observed between the two groups of patients. Conclusions. QOL did not differ in patients with abdominoperineal resection from patients with sphinctersparing surgery.