Comparison of quality of life in patients undergoing abdominoperineal extirpation or anterior resection for rectal cancer

Objective To evaluate the quality of life (QoL) in patients undergoing ante rior resection (AR) or abdominoperineal extirpation (APE) for rectal cancer in a sample of patients recruited from a field trial. Summary Background Data Abdominoperineal resection has been reported to put patients at higher risk of disruption to QoL than sphincter-preserving sur gery. Methods Fifty patients treated with AR and 23 patients treated with APE wer e prospectively followed up. All patients were treated in curative attempt and were disease-free throughout the study. QoL was assessed before surgery and 6 to 9 and 12 to 15 months after surgery. Results Multivariate analysis of variance and subsequent post hoc compariso ns revealed a main effect for time (role function, emotional function, body image, future perspective, and micturition-related problems) and group in favor of APE (sleeping problems, constipation, diarrhea), and a time-by-gro up interaction (role function). No significant results were obtained for th e remaining scores, but patients undergoing APE consistently had more favor able QoL scores than those undergoing AR. Multivariate analysis and post ho c comparisons revealed a particularly poor QoL for patients undergoing low AR. They had a significantly lower total QoL, role function, social functio n, body image, and future perspective, and more gastrointestinal and defeca tion-related symptoms than patients undergoing high AR. Conclusion Patients undergoing APE do not have a poorer QoL than patients u ndergoing AR. Patients undergoing low AR have a lower QoL than those underg oing APE. Attention should be paid to QoL concerns expressed by patients un dergoing low AR.