Urologic and sexual morbidity following multimodality treatment for locally advanced primary and locally recurrent rectal cancer
Aims: In the treatment of patients with locally advanced primary or locally recurrent rectal cancer much attention is given to the oncological aspects. In long-term survivors, urogenital morbidity can have a large effect on the quality of life. This study evaluates the functional outcome after multimodality treatment in these patient groups. Patients and methods: Between 1994 and August 1999, 55 patients with locally advanced primary and 66 patients with locally recurrent rectal cancer were treated with multimodality treatment: i.e. high-dose preoperative external beam radiation therapy, followed by extended surgery and intraoperative radiotherapy. The medical records of the 121 patients were reviewed. To assess long-term urogenital morbidity, all patients still alive, with a minimum follow-up of 4 months, were asked to fill out a questionnaire about their voiding and sexual function. Seventy-six of the 79 currently living patients (96%) returned the questionnaire (median FU 14 months, range 4-60). Results: The questionnaire revealed identifiable voiding dysfunction as a new problem in 31% of the male and 58% of the female patients. In 42% of patients after locally advanced primary and 48% after locally recurrent rectal cancer treatment bladder dysfunction occurred. The preoperative ability to have an orgasm had disappeared in 50% of the male and 50% of the female patients, and in 45% of patients after locally advanced primary and in 57% after locally recurrent rectal cancer treatment. Conclusion: Multimodality treatment for locally advanced primary and recurrent rectal cancer results in acceptable urogenital dysfunction if weighed by the risk of uncontrolled tumour progression. Long-term voiding and sexual function is decreased in half of the patients. Preoperative counselling of these patients on treatment-related urogenital morbidity is important.
|Keywords||Bladder dysfunction, Complications, IORT, Locally advanced, Primary, Radiotherapy, Rectal cancer, Recurrent, Sexual dysfunction, Surgery, Urologic|
|Persistent URL||dx.doi.org/10.1053/ejso.2000.1099, hdl.handle.net/1765/66172|
|Journal||European Journal of Surgical Oncology|
Mannaerts, G.H.H, Schijven, M.P, Hendrikx, A.J.M, Martijn, H, Rutten, H.J.T, & Wiggers, T. (2001). Urologic and sexual morbidity following multimodality treatment for locally advanced primary and locally recurrent rectal cancer. European Journal of Surgical Oncology, 27(3), 265–272. doi:10.1053/ejso.2000.1099