HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Quality of life after surgery for colon cancer in patients with Lynch syndrome: partial versus subtotal colectomy.

AbstractBACKGROUND:
Lynch syndrome is a disorder caused by mismatch repair gene mutations. Mutation carriers have a high risk of developing colorectal cancer. In patients with Lynch syndrome in whom colon cancer has been diagnosed, in general, subtotal colectomy instead of partial colectomy is recommended because of the substantial risk of metachronous colorectal cancer. However, the effect of more extensive surgery on quality of life and functional outcome is unknown.
OBJECTIVE:
The aim of this study was to investigate quality of life and functional outcome in patients with Lynch syndrome after partial colectomy and subtotal colectomy.
DESIGN:
This is a nationwide cross-sectional study in the Netherlands.
SETTINGS:
Two quality-of-life questionnaires (Short Form-36 and The European Organization for Research and Treatment of Cancer Colorectal Cancer-specific Quality of Life Questionnaire Module) and a functional outcome questionnaire (Colorectal Functional Outcome) were used.
PATIENTS:
Patients with Lynch syndrome who underwent surgery for colon cancer were included.
MAIN OUTCOME MEASURES:
The primary outcomes measured were quality of life and functional outcome.
RESULTS:
Questionnaires were sent to 192 patients with Lynch syndrome who underwent surgery for colorectal cancer. A total of 136 patients returned the questionnaire (response rate, 71%). Eighteen patients with rectal cancer, 9 patients with a permanent ileostomy, and 5 patients with an IPAA were excluded. Fifty-one patients underwent partial colectomy, and 53 underwent subtotal colectomy. None of the scales of the Short Form-36 survey showed a significant difference. Analysis of the Colorectal Functional Outcome questionnaire revealed that, after subtotal colectomy, patients have a significantly higher stool frequency (p ≤ 0.01) and a significantly higher score on stool-related aspects (p = 0.06) and social impact (p = 0.03). The European Organization for Research and Treatment of Cancer Colorectal Cancer-specific Quality of Life Questionnaire Module presented more problems with defecation after subtotal colectomy (p ≤ 0.01).
LIMITATIONS:
Certain selection bias cannot be ruled out.
CONCLUSIONS:
Although functional outcome is worse after subtotal colectomy than after partial colectomy, generic quality of life does not differ after the 2 types of surgery in Lynch syndrome. When discussing the options for surgery with the patient, all advantages and disadvantages of both surgical procedures, including quality of life and functional outcome, should be discussed.
AuthorsJasmijn F Haanstra, Wouter H de Vos Tot Nederveen Cappel, Jessica P Gopie, Juda Vecht, Steven A L W Vanhoutvin, Annemieke Cats, Hester J van der Zaag-Loonen, Alexandra M J Langers, Jerry H W Bergmann, Paul C van de Meeberg, Evelien Dekker, Jan H Kleibeuker, Hans F A Vasen, Fokko M Nagengast, Peter van Duijvendijk
JournalDiseases of the colon and rectum (Dis Colon Rectum) Vol. 55 Issue 6 Pg. 653-9 (Jun 2012) ISSN: 1530-0358 [Electronic] United States
PMID22595844 (Publication Type: Journal Article)
Topics
  • Chi-Square Distribution
  • Colectomy (methods)
  • Colorectal Neoplasms, Hereditary Nonpolyposis (genetics, physiopathology, surgery)
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Netherlands
  • Quality of Life
  • Recovery of Function
  • Registries
  • Statistics, Nonparametric
  • Surveys and Questionnaires
  • Treatment Outcome

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: