Background Postoperative bowel dysfunction,also known as low anterior resection syndrome,is common in rectal cancer survivors and significantly impacts quality of life.Although long-term longitudinal follow-up is lacking,im-provement of the syndrome is commonly believed to happen only within the first 2 years.Objective This study aimed to depict the longitudinal evolvement of low anterior resection syndrome beyond 3 years and explore factors associated with changes.Design Longitudinal long-term follow-ups were performed for the single center with the largest cohort within the multicenter FOWARC randomized controlled trial.Setting A quaternary referral center.Patients Individuals di-agnosed with rectal cancer who received long-course neoadjuvant chemotherapy or chemoradiotherapy,followed by sphincter-preserving radical proctectomy.Main outcome measurements Change of low anterior resection syndrome score and stoma status.Results Of the 220 patients responding to the first follow-up at a median of 39 months,178(80.9％)responded to the second follow-up after a median of 83 months.During this interval,the mean low anterior re-section syndrome score improved from 29.5(95％CI,28.3-30.7)to 18.6(95％CI,16.6-20.6).Fifty-six(31.5％)patients re-ported improvement from major to no/minor severity,and 6(3.4％)patients had new stomas because of severe bowel dysfunction.Neoadjuvant radiotherapy(P=0.016)was independently and negatively associated with improvement of the score.Limitations Loss of follow-up during the long-term follow-ups.Conclusions Most rectal cancer survivors with low anterior resection syndrome continued to improve beyond 3 years after proctectomy.Neoadjuvant radiotherapy was nega-tively associated with long-term improvement of low anterior resection syndrome.
关键词
低位前切除综合征/纵向随访/新辅助放疗/直肠癌
Key words
low anterior resection syndrome/longitudinal follow-up/neoadjuvant radiotherapy/rectal cancer
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