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To what extent is the low anterior resection syndrome (LARS) associated with quality of life as measured using the EORTC C30 and CR38 quality of life questionnaires?

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Treatment of rectal cancer often results in disturbed anorectal function, which can be quantified by the Low Anterior Resection Syndrome (LARS) score. This study investigates the association of impaired anorectal function as measured with the LARS score with quality of life (QoL) as measured with the EORTC-QLQ-C30 and CR38 questionnaires.

Methods

All stoma-free patients who had undergone sphincter-preserving surgery for rectal cancer from 2000 to 2014 in our institution were retrieved from a prospective database. They were contacted by mail and asked to return the questionnaires. QoL was evaluated in relation to LARS and further patient- and treatment factors using univariate and multivariate analysis.

Results

Of the eligible patients (n = 331), 261 (78.8%) responded with a complete LARS score. Mean score for global QoL according to the EORTC-QLQ-C30 questionnaire was 63 ± 21 for all patients. If major LARS was present, mean score decreased to 56 ± 19 in contrast to 67 ± 20 in patients with no/minor LARS (p < 0.001). In regression analysis, major LARS was furthermore associated with reduced physical, role, emotional, cognitive and social functioning as well as impaired body image, more micturition problems and poorer future perspective. It was not related to sexual function. The variance explained by major LARS in the differences of QoL was approximately 10%.

Conclusion

The presence of major LARS after rectal resection for cancer is negatively associated with global health as well as many other aspects of QoL. Preserving anorectal function and treatment of LARS are potential measures to improve QoL in this patient group.

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Acknowledgments

The authors are indebted to Lisa Domichowski, Medical Data Manager, for her support in data acquisition. The maintenance of the database at the Coloproctologic Unit of Dresden-Friedrichstadt General Hospital is supported by a grant from the Tumour Centre Dresden.

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Authors and Affiliations

  1. Department of General, Visceral and Thoracic Surgery, Dresden-Friedrichstadt General Hospital, Teaching Hospital of the Technical University of Dresden, Friedrichstr. 41, D-01067, Dresden, Germany

    Juliane Kupsch, Olga Radulova-Mauersberger, Anja Sims, Helmut Witzigmann & Sigmar Stelzner

  2. Institute for Medical Informatics and Biometry, (Carl Gustav Carus) Faculty of Medicine, Technische Universität Dresden, Blasewitzer Str. 86, D-01307, Dresden, Germany

    Matthias Kuhn

  3. Department of Surgery, Section Coloproctology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Krankenhausstr. 12, D-91054, Erlangen, Germany

    Klaus E. Matzel

  4. Department of Radiation Therapy, Dresden-Friedrichstadt General Hospital, Teaching Hospital of the Technical University of Dresden, Friedrichstr. 41, D-01067, Dresden, Germany

    Joerg Zimmer

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  1. Juliane Kupsch
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Correspondence to Sigmar Stelzner.

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Kupsch, J., Kuhn, M., Matzel, K.E. et al. To what extent is the low anterior resection syndrome (LARS) associated with quality of life as measured using the EORTC C30 and CR38 quality of life questionnaires?. Int J Colorectal Dis 34, 747–762 (2019). https://doi.org/10.1007/s00384-019-03249-7

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